Best time for craniotomy for cerebral hemorrhage

The operation time of cerebral hemorrhage is, in principle, the earlier the better, removing hematoma as early as possible, eliminating the compression of hematoma, reducing the stimulation of hematoma to the surrounding brain tissues, which is helpful for the recovery of neurological function. However, analyzing from the favorable aspects of surgical operation, the best time for surgery is not the earlier the better. Ultra-early cerebral hemorrhage is defined as within six hours after cerebral hemorrhage, during the operation, due to the unstable bleeding, the bleeding is not completely coagulated, the bleeding in the operation area is more oozing, and it is difficult to stop the bleeding, and it is easy to rebleed after the operation. Early cerebral hemorrhage refers to six to twenty-four hours after bleeding, at this time the bleeding has been basically stabilized, a blood clot has been formed, the edema band around the hematoma is formed, it is easy to remove the hematoma during the operation, it is not easy to bleed, it is relatively easy to stop the bleeding, and the risk of postoperative rebleeding is relatively small. Late cerebral hemorrhage is more than twenty-four hours after the hemorrhage, this period of time, the hematoma has been partially mechanized, hardened, and has adhesion with the surrounding brain tissue, the operation is not easy to suction the hematoma, forced suction is easy to cause hemorrhage, aggravate the injury and rebleeding, and it is difficult to stop bleeding. Although from the analysis of the favorable aspects of surgical operation, 6-24 hours is an easy time for cerebral hemorrhage surgery, but from the analysis of the patient’s benefit, it is still recommended that six hours or less is the best time for surgery, and the earlier the better.