In recent years, minimally invasive removal of intracranial hematoma for the treatment of hypertensive cerebral hemorrhage has achieved positive clinical efficacy, but there is still no shortage of fatal cases. The causes of death are analyzed as follows: 1. Brain herniation: brain herniation is the first cause of death, accounting for 42.1%. The reasons are: (1) The occupying effect of large hematoma and edema reaction around the hematoma after bleeding are the main causes of intracranial hypertension and the occurrence and development of brain herniation. The use of single-needle puncture and drainage cannot effectively remove the hematoma in the short term, and the intracranial pressure cannot be reduced in time to relieve the level of brain herniation, and the brainstem is further damaged and dies. It is recommended to perform multi-level multi-needle puncture treatment for massive cerebral hemorrhage. (2) Separated hematoma is separated into multiple cavities by normal brain tissue and separated from each other, which affects the amount of hematoma drainage, at which time double needle aspiration can be considered. (3) The application of dehydrating drugs (mannitol and tachyphylaxis) before aspiration not only causes dehydration of the brain tissue outside the hematoma, but also causes the clot to retract, which makes aspiration more difficult. In addition, the application of mannitol at the early stage of the disease can increase the pressure gradient between the hematoma and the brain tissue, which can lead to the expansion of the hematoma, so dehydrating agents should not be applied before minimally invasive treatment. (4) Patients with hypercoagulable state, hyperviscosity, and hyperlipidemia have increased difficulty in aspiration because of rapid blood coagulation. For the above patients with difficult drainage and large hematoma, craniotomy should be performed promptly to remove the hematoma. 2, MODS: the second cause of death, accounting for 29.8%. Hypertensive cerebral hemorrhage is seen in elderly patients with less than satisfactory control of hypertension, most of the patients are complicated by diseases of the heart, lungs and kidneys and other important organs, due to morbidity and surgical shock, in a state of severe stress, a slight dysfunction of an organ can lead to a chain reaction, the emergence of MODS. suggests that for elderly patients should pay particular attention to the prevention and treatment of MODS. 3, renal failure: patients with renal failure as the third cause of death, accounting for 15.8%. Long-term hypertensive patients, renal artery sclerosis, renal insufficiency, cerebral hemorrhage, due to the application of a large number of dehydrating agents and failure to timely feeding or rehydration, resulting in insufficient blood volume, so that the kidney further ischemia, in the case of poor renal function complications of acute renal failure. Therefore, for elderly patients with hypertensive cerebral hemorrhage, the use of dehydrating agents, especially mannitol, should be reduced and attention should be paid to monitoring renal function. 4, pulmonary infection: the fourth cause of death, accounting for 12.2%. After hypertensive cerebral hemorrhage, due to neurological dysfunction or increased intracranial pressure in the brain, vomiting, gastric reflux aspiration and pulmonary edema of patients, pulmonary infections are likely to occur, resulting in an imbalance between alveolar ventilation and blood perfusion, systemic hypoxemia and hypercapnia, resulting in cerebral hypoxia, aggravated cerebral edema and further aggravation of brain damage, leading to death of patients. Therefore, respiratory management should be strengthened, respiratory conditions should be closely observed, and respiratory secretions should be suctioned and removed in a timely manner. Postoperative antibiotic treatment and strengthening systemic supportive therapy should be carried out to reduce the occurrence of pulmonary infection. Meanwhile, a variety of complications such as concomitant hyperthermia, gastrointestinal bleeding, and convulsions can aggravate the development of the above-mentioned mortality factors and lead to death.