Minimally invasive hematoma puncture surgery for spontaneous thalamic hemorrhage has been carried out in the Department of Emergency Surgery, and more than 30 cases have been completed, reducing surgical trauma, significantly shortening surgery and hospitalization time, reducing patient costs, improving patient prognosis, and achieving good treatment results and socioeconomic benefits. Spontaneous thalamic hemorrhage accounts for 10-15% of hypertensive cerebral hemorrhage and is the more common type of hemorrhage, often breaking into the ventricles and causing ventricular hemorrhage, or compressing the midbrain and causing obstructive hydrocephalus. Because the thalamus is adjacent to important fiber conduction tracts and has a close relationship with the midbrain, hemorrhage in this area may cause symptoms such as hemiparesis, hemianesthesia, hemianopsia, or even death due to the involvement of the midbrain in severe cases, and is the most critical site of spontaneous cerebral hemorrhage other than the brainstem. The traditional treatment for thalamic hemorrhage is external drainage of the lateral ventricle, which can only solve the blood accumulation in the ventricles, but can do nothing about thalamic hemorrhage, the main factor causing hemiparesis and impaired consciousness. Since 2012, minimally invasive thalamic hematoma puncture and drainage surgery has been performed in the Department of Emergency Surgery with good results. The puncture point, puncture direction and puncture depth are the three elements of minimally invasive hematoma puncture, which is difficult due to the small volume and deep location of thalamic hemorrhage. Currently, through continuous exploration and practice, the department has summarized a set of effective diagnosis and treatment standards, and has been able to accurately puncture thalamic hematomas as small as 10 ml, and to remove most of the hematomas within a few days by postoperative injection of urokinase to promote clot disintegration and other methods. Preoperative intraoperative 2 days postoperative 7 days postoperative