Cerebral hemorrhage caused by hypertension accounts for about 60%-80% of all patients with cerebral hemorrhage, and the mortality rate of patients is very high. When a patient has a cerebral hemorrhage, blood gushes out the moment the blood vessel ruptures, and the hematoma not only compresses the local brain tissue, but also aggravates the damage to the surrounding brain tissue and blood vessels. The increased intracranial pressure caused by the hematoma and the displacement of brain tissue under pressure leads to brain herniation, which is the direct cause of death of the patient. For patients with hypertensive cerebral hemorrhage, it is critical to choose the right treatment at the right time. The rate and amount of bleeding varies from patient to patient, in addition to the location of the bleeding, thus each patient’s situation is different. How to get a good treatment effect, the treatment of hypertensive cerebral hemorrhage focuses on the choice of method, only after choosing a suitable treatment method, can guarantee patients have better treatment effect. 1, early detection, early consultation When you find that your family member has a spike in blood pressure, headache, inflexibility of hands and feet, vomiting, coma and other symptoms, you should be alert to cerebral hemorrhage. Family members should send the patient to the hospital for treatment as early as possible. Early surgery for patients with hypertensive cerebral hemorrhage under suitable conditions to remove the hematoma before irreversible damage is formed in the brain parenchyma and interrupt the vicious cycle chain can minimize the damage to the brain parenchyma, and it is best to operate within 24 hours after the appearance of symptoms, with the best results within 6 hours. Resuscitation at this time plays an important role in the patient’s life and postoperative neurological function recovery. 2. Dynamic observation and selection of appropriately chosen treatment modality Are all brain hemorrhages in need of surgery? Actually, it is not quite true. Generally speaking, surgery is only considered when the amount of cerebral hemorrhage reaches a certain amount and any of the following conditions occur: (1) supratentorial cerebellar hematoma exceeding 30 ml (in the brain) with a midline shift of 1 cm; (2) subscale hemorrhage greater than 10 ml (in the cerebellum); (3) intraventricular hemorrhage with formation of obstructive hydrocephalus. It is important to emphasize that the amount of bleeding is closely related to the rate of bleeding, and the amount of bleeding may increase within 48h after the onset of the patient. Remember to be more vigilant, and even if the indication for surgery is not reached at the time of consultation, it is still necessary to dynamically observe the patient’s condition and promptly review the cranial CT to determine the changes in the amount of bleeding and the edema of the surrounding brain tissue. The purpose of surgery is to remove the hematoma, lower the intracranial pressure, prevent and reduce the vicious cycle caused by a series of secondary changes such as blood cell decomposition and brain tissue edema after hemorrhage, and improve the survival rate and quality of life; in addition, after lowering the cranial pressure, the blood pressure is also conducive to control. There are numerous surgical methods to treat hypertensive cerebral hemorrhage. It cannot be fully described which surgical method is superior or inferior, and the appropriate surgical method must be selected based on a comprehensive consideration of the condition, state of consciousness and hematoma. Depending on the type and the amount of hematoma, the cerebral hemorrhage with hypertension is treated by drilling the cranial ventricle for external drainage and/or craniotomy for hematoma removal, and in some patients, even partial removal of the skull for decompression. The removal of hematoma and reduction of intracranial pressure can be achieved in different types and volumes of hypertensive cerebral hemorrhage. Patients who are too old and frail or suffer from cardiopulmonary insufficiency to tolerate craniotomy are treated with cranial drilling or stereotactic surgery.