Recently, a female patient, 77 years old, was admitted to our neurosurgery department with “3 hours of inability to breathe”. Examination: coma, tingling limb flexion, bilateral pupils 1mm, dull light reflex, right limb muscle strength grade 0 bilateral Babinski (-), Glasgow score 5. Diagnosis: hypertensive cerebral hemorrhage. The hemorrhage volume was 75ml, and minimally invasive debridement was performed under local anesthesia on the same day, and the puncture needle was removed on the fifth day after the operation, and the hematoma was basically cleared. Previous neurosurgical management of this type of hemorrhage requires large bone flap craniotomy to remove the hematoma, which is traumatic, high-risk, with many complications and prolonged recovery period. This method of treatment for elderly patients with cerebral hemorrhage has fewer postoperative complications, shorter recovery time, and is easily accepted by patients.