Cerebral hemorrhage accounts for 20-30% of all strokes, with an annual incidence of 12-15/100,000. 30-50% mortality in 6 months and a very poor long-term prognosis. Only 20% can take care of themselves. This is a rapid onset, slow recovery, and requires long-term treatment and care. And loss of labor force. Bring disaster to society and family. Etiology The first is hypertensive disease, accounting for about 60 ∽ 70%; followed by amyloidosis, accounting for about 15%. Amyloidosis has a high rate of rebleeding. Especially uncontrolled blood pressure and climate change predispose to trigger. The volume increases by 1/3 within 3 hours after bleeding in about 1/3 of patients, with little relation to the volume and site of bleeding. It is related to the time of onset and whether the blood pressure is controlled. Early surgery has no preventive effect on this rebleeding, and the incidence of rebleeding decreases significantly after 24 hours. Indications for surgery Subscriptive <10 ML and supratentorial <30 ML hematoma volumes should be treated conservatively; subscriptive ≥10 ML and supratentorial ≥30 ML hematoma volumes advocate surgical treatment, including craniotomy and puncture surgery. If brain herniation occurs, only craniotomy can be performed as early as possible, and craniotomy should also be used for subcurtain hematoma, and cervical pool and posterior arch of atlantoaxial spine should be opened to decompress completely, and if drowsiness and lethargy are evident in the mind and vital signs are stable, puncture surgery can be chosen with little injury, which is especially suitable for elderly people and patients with multiple underlying diseases who cannot tolerate general anesthesia; if both craniotomy and puncture surgery can be chosen, less traumatic puncture surgery should be preferred. It can significantly reduce the occurrence of postoperative complications, fast recovery, and reduce costs. If combined with rupture into the ventricle at the same time, external ventricular drainage is performed. The following are a few examples of successful punctures and comparative preoperative and postoperative CT films, all of which were performed under local anesthesia.