Cerebral hemorrhage is a spontaneous cerebrovascular disease in the brain parenchyma caused by the rupture of arteries, veins or capillaries in the brain. Hypertensive cerebral hemorrhage is a global disease with high morbidity, disability and mortality, and is both a common and serious health hazard. The common sites include basal ganglia hemorrhage (also called internal capsule hemorrhage), pontocerebellar hemorrhage, cerebellar hemorrhage, ventricular hemorrhage, etc. About 80% of the hemorrhages occur in the cerebral hemisphere, with the basal ganglia as the main area, and the remaining 20% occur in the brain stem and cerebellum. Hypertension and atherosclerosis are the main factors of cerebral hemorrhage, which can also be caused by congenital cerebral aneurysm, cerebrovascular malformation, brain tumor, hematological diseases (such as aplastic anemia, leukemia, thrombocytopenic purpura and hemophilia), infection, drugs (such as anticoagulation and thrombolytic agents), trauma and poisoning, etc. 1.Clinical characteristics: Sudden onset of severe headache, and mostly accompanied by agitation, drowsiness or coma. The clinical manifestations are different according to the site of bleeding. The clinical manifestations are different according to the site of hemorrhage. Hemorrhage in the nucleus accumbens and basal ganglia is the most common site of hypertensive cerebral hemorrhage, which mostly affects the internal capsule. The cerebral bridge hemorrhage often starts suddenly and enters a deep coma within minutes, and the condition is critical. The cerebral bridge hemorrhage often starts on one side of the cerebral bridge and spreads rapidly to both sides, resulting in bilateral limb paralysis. Most of them are flaccid, a few are spastic or decorticate tonic, and bilateral pathological reflexes are positive. The characteristic sign is extreme narrowing of the pupils on both sides in a “pinpoint” fashion. Some patients may develop central hyperthermia, irregular breathing, and respiratory distress, and often die within 1 to 2 days. Patients with mild cerebellar hemorrhage are clearly conscious at the onset, often complaining of severe headache and vertigo on one side of the posterior occipital region, frequent vomiting, slurred pronunciation, and nystagmus. The limbs are often not paralyzed, but ataxia develops on the side of the lesion. When the hematoma gradually enlarges and breaks into the fourth ventricle, it may cause acute hydrocephalus. In severe cases, herniation of the foramen magnum occurs, and the patient suddenly falls into coma, has irregular breathing or even stops, and eventually dies due to respiratory and circulatory failure. 2.Examination CT examination of the head can show the amount and location of cerebral hemorrhage. 3.Treatment There are conservative treatment and surgical treatment. Non-surgical treatment includes absolute bed rest, sedation and blood pressure stabilization, application of dehydrating drugs, hemostatic drugs, maintenance of water and electrolyte balance, supportive therapy, and attention to keep the airway open. Comatose patients should be meticulously cared for and complications such as pneumonia and gastric bleeding should be prevented and treated in a timely manner. Internal treatment is indicated for the following conditions: (1) Smaller bleeding volume. It is generally considered that internal therapy can be performed for shell nucleus hemorrhage or subcortical hemorrhage less than 30 ml or hematoma diameter less than 3 cm. (2) Those who have been conscious or only drowsy after bleeding. (3) The patient is in a deep coma after the onset, or the disease has progressed to an advanced stage, and the coma is not suitable for surgical treatment. (4) Patients who are very old and have heart, lung and kidney diseases, or have severe diabetes mellitus. Surgical treatment of hypertensive cerebral hemorrhage should be valuable only when non-surgical treatment has failed and the hemorrhage has not yet caused primary or secondary fatal damage. The purpose of surgical treatment is to remove the hematoma, lower the intracranial pressure, relieve the occurrence and development of cerebral herniation, improve cerebral circulation, and promote early recovery of the compressed brain tissue. Surgical treatment can be divided into open hematoma removal or stereotactic aspiration of the brain to remove the hematoma. Brain stereotactic hematoma aspiration has precise localization and little surgical damage, which is especially suitable for hematoma removal in deep brain or important functional areas. 4. Prevention Patients with hypertension should control blood pressure under the guidance of physicians and avoid factors that may induce an increase in blood pressure, such as strenuous exercise and forceful defecation. If severe posterior lateral headache or collar pain, motor sensory impairment, vertigo or syncope, nasal bleeding, blurred vision, etc. may be precursors of cerebral hemorrhage, they should go to hospital for examination in time.