Hypertensive cerebral hemorrhage is a spontaneous hemorrhage in the brain of hypertensive patients, a global disease with high morbidity, disability and mortality, and a common but serious disease that endangers human health. Hypertensive cerebral hemorrhage is mostly transient, and hematoma enlargement occurs within 6h, especially within 3h. The local brain tissue around the hemorrhage site is firstly affected by the impact of arterial blood flow to produce primary damage, followed by intracerebral hematoma formation and local high pressure causing pressure displacement, ischemia, edema and necrosis of the surrounding brain tissue. The hematoma is also in different states depending on the stage of the disease, such as coagulation, liquefaction or cyst formation, with a softening zone around the hematoma cavity. In the acute stage, cerebral edema around the hematoma is obvious, and the hemisphere increases in volume, compressing the lateral ventricle and causing it to deform significantly and shift to the opposite side or even forming brain herniation, resulting in brainstem distortion and compression, which is often the direct cause of death from cerebral hemorrhage. Hypertensive cerebral hemorrhage occurs most frequently in the basal ganglia of the brain, accounting for about 2/3 of cerebral hemorrhage, with shell nucleus hemorrhage being more common, accounting for 44%, thalamic hemorrhage 13%, pontocerebellar hemorrhage 9%, cerebellar hemorrhage 9%, and other parts accounting for about 25%. Hypertensive cerebral hemorrhage mostly occurs in hypertensive patients over 50 years old, and usually develops when they are emotionally excited, overexcited, defecating, holding their breath and exerting themselves, or when they are mentally stressed. Cerebral hemorrhage is often unpredictable before, occurs suddenly, has a rapid onset, and often develops to a peak within minutes to hours. The clinical manifestations depend on various factors such as the site of hemorrhage, the extent of hemorrhage, the body’s reaction, and the general condition: 1. Hemorrhage in the nucleus accumbens and basal ganglia: it is the most common site of hypertensive cerebral hemorrhage, mostly affecting the internal capsule, and the patient often has the head and eyes turned to the side of the hemorrhagic lesion, showing a “focal gaze” and “three deviations The patient often has the head and eyes turned to the side of the hemorrhagic lesion, showing the “gaze lesion” and “three deviations” symptoms, i.e. hemiparesis, hemianesthesia and hemianopsia. 2. Pontocerebral hemorrhage: It often occurs suddenly and enters deep coma within minutes, and the condition is critical. The hemorrhage often starts from one side of the pontocerebrum first and rapidly spreads to both sides, with bilateral limb paralysis, mostly flaccid, a few spastic or de-cerebral tonic, and positive bilateral pathological emission. The pupils on both sides are extremely narrowed in a “pinpoint-like” manner, which is the characteristic sign. 3. Cerebellar hemorrhage: Light patients are clear-headed at the onset, often complaining of severe headache and vertigo in the posterior occipital region, frequent vomiting, slurred pronunciation, and nystagmus. The limbs are often not paralyzed, but the limbs on the side of the lesion appear ataxic. 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. 4. Subcortical hemorrhage in the cerebral lobe: the symptoms are related to the size of the hematoma. Symptoms such as headache, vomiting, photophobia and irritability are usually present, and the corresponding neurological deficits in the cerebral lobes are more prominent. Since cerebral hemorrhage is so dangerous, what is its culprit? For hypertensive patients, hypertensive disorders are the most important cause of brain hemorrhage, which is the most serious consequence or complication of hypertensive disorders. Therefore, in daily life, hypertensive patients should set time, place, position and blood pressure meter to measure blood pressure carefully and record it, take medication on time, avoid overexertion or emotional excitement, pay attention to diet to keep intestines open and avoid forceful bowel movement, etc. If sudden onset of headache, accompanied by vomiting, limb paralysis, aphasia, impaired consciousness and other conditions should be highly suspected of cerebral hemorrhage may be, should go to the hospital early to do cranial CT examination, in order to clear the diagnosis, to prevent delay in the condition and rescue, resulting in irreversible consequences.