| Background and purpose Cerebral stroke is the third reason of human death and cause hospitalization and incapability for a long time. Hypertensive Intracerebral Hemorrhage (HICH) means intracephalic bleeding by the reason of vascular hypertension and about 10 percent of the cerebral apoplexy, 90 percent of the nbn-trumatogenic encepalorrhagia. HICH is the common disease in the bad way that occurs frequently at clinical Neurology, which access unexpectedly, make progress rapidly and has high mortality (40~60 percent)and mutilate rate. It is the serious complication and main death reason of hypertension patients which death rate heads the list of cerebrovascular disease.Along with the extensive use of CT, MRI and MRA, in depth study of pathology, accumulation of clinical medicine and use of stereotactic operating, curative effect and viability of HICH has been upgraded greatly. Therefore, surgical operating of HICH became heat subject in neurosurgeons. There are more surgical methods without a uniform standard in treating HICH in our country, and it has a different mortality.The theory of secondary insults had been suggested by Miller in 1978. It means that the changes of the secondary insults just like blood pressure, body temperature, intracranial pressure, cerebral blood flow and cerebral perfusion pressure will be cause secondary brain injury. These insults will beexacerbating the primary head injury and traumatic cerebral edema. Indication of clinical data, the incidence rate of secondary insults is 44.5%. Compare with pure brain injury, the patients who incorporating distinct changes of temperature and blood pressure have the heighten death and disability rate.There is no a correlation research about the incidence rate of secondary insults in HICH. Our data displayed that it has a highly incidence rate which the secondary insults occur in HICH patients. And the secondary insults influence the prognosis of HICH patients immediately. The reason is there is many changes of secondary insults just like vascular hypertension, highly temperature, highly intracranial pressure and it has the relationship with the prognosis of patients. It has the significance to raise the cure effect that treat and prevent the secondary injuries as soon as possible.Method We sum up the clinical data of 112 HICH patients with 73 male and 39 female. The admitted patients were divided to group of craniotomy and group of drainage randomly. Evaluate the prognosis by Compare with the GCS, operating methods, treatment time, hematoma volume and secondary insults.Admission rules: 1. spontaneity intracerebral hemorrhage confirmed by CT scan. 2. GCS points not under to 5. 3. the hemotoma volume more than 20ml in hemisphere and 10ml in cerebellar. 4. age of the patients not less than 30 years old. Elimination rules: 1. the hemorrhage by aneurysm or AVMs. 2. hematoma by brain injury or tumor apoplexy. 3. brain stem hemotoma. 4. the patients elder than 70 years old with batho-coma; e. hernia of brain in advanced stage, amb-mydrasis, decerebrate rigidity and have pathological breath; f. severe original disease or dysgnosia.Results1.Effect of GCS: 16 patients have good recovery, 20 have moderate disability and no death who with GCS 13-15. Only one patient has good recovery, 4 patients have moderate disability, 9 patients have severe disability and 7 have persistent vegetative or death who with GCS5-8. That displayed significant deviation betrwen the two groups (P<0.05 ) .2. Effect to prognosis by different modus operandi: the GOS which signature the prognostic indicator in the near future has no significant deviation bettwen craniotomy group and puncturation group (P>0.05) .Also has no significant deviation bettwen the two groups in long-term prognostic indicator ADL (P>0.05) .3. Effect to prognosis by operation opportunity: 36 patients with operation at hyper-morning (within 7 hours after to hemorrhage) have good revovery and no patient have severe disability, persistent vegetative or deat...
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