Objective
The morbidity and mortality rate of hypertensive cerebral hemorrhage is generally 50% to 60% with conservative medical treatment. The traditional surgical treatment is bone flap craniotomy for hematoma removal, which requires general anesthesia, long operation time, and large trauma. It has not been able to reduce the morbidity and mortality rate. The aim of this project is to explore the minimally invasive, effective and simple treatment pathway. We also study the indications, timing of surgery, complications, and application of hematoma liquefying agents in minimally invasive surgery for hypertensive cerebral hemorrhage, and analyze the preoperative factors related to the prognosis of hypertensive cerebral hemorrhage. Conclusion 1. Indications There is no absolute contraindication to surgery. This group mainly applied to grade I, II and III. 2. Timing of surgery Ultra-early removal of hematoma within 6 hours of cerebral hemorrhage is necessary to improve survival rate and quality of life. If the hematoma is located in a very important functional area and the amount of hematoma has not caused changes in vital signs, the treatment time can be extended appropriately, but preferably not more than 24 hours. 3.Complications The complications of this treatment are most serious with rebleeding, which may be due to large fluctuations in blood pressure. 4.Application of hematoma liquefying agent Therefore, it is better to apply urokinase to drain and flush for 12-24 hours clinically. We injected urokinase dissolved in patient’s autologous serum into the hematoma cavity to achieve similar effect, but it is safer. 5. Prognosis Preoperative blood pressure, level of consciousness, bleeding volume, intracranial pressure, and neurological deficit are related to the prognosis; the site of bleeding is inextricably related to the prognosis.