Comparison treatments for basal ganglia hemorrhage: minimally invasive puncture and drainage versus craniotomy versus conservative treatment

Objective To evaluate the efficacy of stereotactic hematoma evacuation surgery for hypertensive cerebral hemorrhage in basal ganglia region. Methods A retrospective analysis was performed on 65 cases of hypertensive cerebral hemorrhage in the basal ganglia from August 2015 to March 2018 at the Stereotactic and Neurofunctional Center of the 306th Hospital of PLA. According to different surgical methods, those patients were divided into 2 groups. In the hematoma puncture group, 35 patients underwent hematoma puncture and drainage surgery; in the stereotaxis group, 30 patients underwent stereotactic puncture and catheter drainage surgery assisted by robot Remebot. The baseline conditions, bleeding time, volume of hematoma, preoperative GCS (Glasgow coma scale) score, Barthel score before discharge and at 3 months post operation, and the time of thorough hematoma drainage were compared between the 2 groups. Results (1) The time for thorough hematoma drainage in the stereotaxis group was significantly less than that in the hematoma puncture group. There was a significant difference between the 2 groups (Z=3.69, P<0.01). (2) Barthel scores before discharge (89.7±7.2) and at 3 months post operation (94.0±5.7) in stereotaxis group were significantly higher than those in hematoma puncture group (before discharge: 75.3±7.2, 3 months post operation: 76.4±8.2, both P<0.01). Conclusion Stereotactic hematoma evacuation surgery could significantly accelerate the removal time of hematoma in patients with hypertensive intracerebral hemorrhage, quickly relieve the compression of brain tissue by hematoma and promote the recovery of neurological function. Key words: Intracranial hemorrhage, hypertensive; Basal ganglia; Neurosurgical procedures; Stereotactic; Treatment outcome

Introduction: Previous studies suggested that low cerebral blood volume (CBV) lesion predicts hemorrhagic transformation after endovascular therapy. Hypothesis: We assessed the hypothesis that delays in time to reperfusion lead to hemorrhagic transformation on T2*-weighted MRI after endovascular therapy in patients with low CBV obtained from pre-treatment CT perfusion (CTP). Methods: We retrospectively analyzed 62 consecutive patients with acute ischemic stroke who were obtained successful reperfusion (TICI 2A-3) by endovascular thrombectomy for internal carotid artery or M1 occlusion. CTP maps were assessed for relative CBV (rCBV) values obtained separately for cortical and basal ganglia regions in the MCA territory. The presence of cortical and basal ganglia hemorrhage (either HI or PH) was assessed on T2*-weighted MRI after endovascular therapy. We analyzed the influence of rCBV in each region, CTP-to-reperfusion time and degree of reperfusion on cortical and basal ganglia hemorrhage. Results: Forty patients developed hemorrhagic transformation. HIs occurred in 16, PH1s in 21, PH2s in 3 and symptomatic hemorrhage in 1 of the patients. rCBV of the cortical region (0.77 versus 0.98, P=0.002) and basal ganglia region (0.64 versus 0.88, P&lt;0.001) were significantly lower in the patients with hemorrhage than in those without. There was no significant difference in CTP-to-reperfusion time between cortical hemorrhage and no cortical hemorrhage groups. However, in the patients with low cortical rCBV (rCBV &lt;0.8) and TICI ≥2b, mean CTP-to-reperfusion time was significantly shorter (70 versus 108 minutes, p=0.021) in the non-cortical hemorrhage group. There was no significant difference in CTP-to-reperfusion time between basal ganglia hemorrhage and non-basal ganglia hemorrhage groups. Conclusions: Early reperfusion decreases risk of cortical hemorrhage in patients with low cortical rCBV. Low rCBV in basal ganglia region is more predictive of basal ganglia hemorrhage than time to reperfusion.

Two prevalent therapies for the treatment of spontaneous intracerebral hemorrhage (ICH) in basal ganglia are, minimally invasive puncture and drainage (MIPD), and endoscopic surgery (ES). Because both surgical techniques are of a minimally invasive nature, they have attracted greater attention in recent years. However, evidence comparing the curative effect of MIPD and ES has been uncertain. The indication for MIPD or ES has been uncertain till now. In the present study, 112 patients with spontaneous ICH in basal ganglia who received MIPD or ES were reviewed retrospectively. Baseline parameters prior to the operation, evacuation rate (ER), perihematoma edema, postoperative complications, and rebleeding incidences were collected. Moreover, 1-year postictus, the long-term functional outcomes of patients with regard to hematoma volume (HV) or Glasgow Coma Scale (GCS) score were judged, respectively, by the case fatality, Glasgow Outcome Scale (GOS), Barthel Index (BI), and modified Rankin Scale (mRS). The ES group had a higher ER than the MIPD group on postoperative day 1. The MIPD group had fewer adverse outcomes, which included less perihematoma edema, anesthetic time, and blood loss, than the ES group. The functional outcomes represented by GOS, BI, and mRS were better in the MIPD group than in the ES group for patients with HV 30–60 mL or GCS score 9–14. These results indicate that ES is more effective in evacuating hematoma in basal ganglia, while MIPD is less invasive than ES. Patients with HV 30–60 mL or GCS score 9–14 may benefit more from the MIPD procedure than from ES.

Objectives: Spontaneous intracerebral hemorrhage (ICH) is a devastating disease with higher mortality and disability rates; however, ideal surgical management is still to be determined for critical ICH. The purpose of this study was to prove the feasibility and unique clinical value of a novel combination, decompressive hemicraniectomy associated with ultrasound-guided minimally invasive puncture and drainage (DH + MIPD), for deteriorating ICH in the basal ganglia region.Methods: According to the enrollment criteria, 168 ICH patients were analyzed retrospectively, of which 86 patients received DH + MIPD and 82 patients received DH associated with traditional hematoma evacuation as the control group. The change process of three parameters, including hematoma size, peri-hematoma edema, and intracranial pressure (ICP), in a period of time after operation, as well as the short- and long-term therapeutic effect, was compared.Results: The DH + MIPD method could effectively achieve the evacuation rate of hematoma up to 87% at 5 days post-operation and had the significant advantages of minimal injury to cerebral tissue, less degree of edema, better effect of decreasing ICP, shorter operation time, less blood loss, and lower mortality compared with the control method. The DH + MIPD group had a significantly higher survival rate within 1 year post-operation (P = 0.007) and better functional outcome at 90 and 180 days post-operation (P = 0.004). A subgroup analysis pointed out that the DH + MIPD method had a definite survival advantage for critical ICH patients older than 60 years old and with hematoma located in the left dominant hemisphere.Conclusions: Our results proved the better feasibility of DH + MIPD on hematoma evacuation and implicated its significant advantages of reducing mortality and improving functional recovery. This method provides one more choice for the individualized therapy of ICH in the basal ganglia region.

BackgroundThe treatment for spontaneous intracerebral hemorrhage (ICH) is still controversial, especially for hematomas in the basal ganglia. A retrospective case-control study with propensity score matching was performed to compare the outcomes of conventional craniotomy and conservative treatment for patients with minor ICH in the basal ganglia.MethodsWe retrospectively collected the data of consecutive patients with minor basal ganglia hemorrhage from January 2018 to August 2019. We compared clinical outcomes of two groups using propensity score matching. The extended Glasgow outcome scale obtained by phone interviews based on questionnaires at a 12-month follow-up was used as the primary outcome measure. According to a previous prognosis algorithm, patients were divided into good and poor prognosis groups to obtain a dichotomized (favorable or unfavorable) outcome as the primary outcome. Secondary outcomes included hospitalized complications, mortality, and modified Rankin score at 12 months.ResultsA total of 54 patients were analyzed, and the baseline characteristics of patients in the surgery and conservative treatment groups were well matched. The primary favorable outcome at 12 months was significantly higher in the conservative treatment group than in the surgery group (81% vs 44%; OR 1.833, 95% CI 1.159–2.900; P=0.005). The incidence of pneumonia in the surgery group was significantly higher than that in the conservative treatment group (P=0.005).ConclusionsIt is not recommended to undertake conventional craniotomy for patients with a minor hematoma (25–40 ml) in the basal ganglia. An open craniotomy might induce worse long-term functional outcomes than the conservative treatment.

Objectives: The overall main purpose of this study is to add some knowledge on the treatment of LCPD, with a main focus on the comparison between conservative and surgical treatments of Legg-Calve-Perthes Disease (LCPD). And a brief overview of the complications of these treatments. Methods: A retrospective cohort method was used in this study. A total number of 53 patients were registered with LCPD, at the first affiliated hospital of Xinjiang Medical University. Out of these 53 patients, 39 patients were included in this study, rest of 14 patients couldn’t be included due to missed data or loss of contact. For the comparison of results, a modified form of the Harris Hip Score (HHS) was used for the clinical assessment of hip function. Radiographs were also used for the evaluation. The radiological assessment was made by the use of CE and CCD angles. The main classification system, which was used for the evaluation, staging, and prognosis of hip function, was Stulberg’s classification. Statistical analysis was done by using the SPSS 23.0 version. A simple t-test was used for data analysis. Results: The clinical results supported our hypothesis that surgical treatment is a better choice of treatment than conservative treatment in patients with LCPD. However, the statistical data from radiographic assessment showed no significant difference between conservative and surgical treatment in patients with LCPD. The statistical data showed that both conservative and surgical treatment had significant p-values (&lt;0.05) when compared results at the final follow-up check with that before starting treatment. So conservative treatment can be used as an alternative to surgical treatment in patients with Legg-Calve-Perthes Disease. Conclusion: From the statistical analysis of data, we concluded that there is no significant difference between outcomes of conservative and surgical treatment in patients with Legg-Calve-Perthes Disease (LCPD). So conservative treatment can be ........

Objective To analyze the related influence factors on the prognosis of hypertensive cerebral hemorrhage in basal ganglia with operation treatment, provide the basis for clinical prevention and treatment. Methods 80 patients for treatment of hypertensive cerebral hemorrhage were selected.By a retrospective study, we collected the clinical data and postoperative following-up data, status, complications, and observed the postoperative recovery. Statistical different hypertension, preoperative breaking into the ventricle, disturbance of consciousness, operation time and preoperative hematoma volume of the prognosis. Results In 80 patients,48 cases(60.00%)of patients has good prognosis; moderate disability, taking care of themselves life 10 cases(12.50%); severe disability, life can not take care of 9 cases(11.25%); plant survival of 5 cases(6.25%)and 8 cases of death(10.00%).22 cases of patients with brain hemorrhage again,3 cases postoperative pulmonary infection, 6 cases of secondary organ dysfunction.Poor prognosis of preoperative ventricle prognosis and disturbance of consciousness of patients was 88.26%(18/23)and 63.64%(21/33),which was higher than the preoperative without breaking into the ventricle and no disturbance of consciousness 24.54%(14/57)and 36.36%(21/33), the difference was statistically significant(χ2=10.38,9.76,P 60m L was 47.62% (20/42),which was higher than the preoperative hematoma volume 40-60m Lpatients31.38%(12/38),the difference was statistically significant(χ2=9.12,P<0.05). Conclusion It has obvious effect on surgery operation prognosis of patients with hypertensive cerebral hemorrhage, including optimal time for operation; bleeding time, intraventricular hemorrhage, disturbance of consciousness and bleeding volume.If the clinical treatment in the prevention and treatment to improve the survival and quality of life of patients with cerebral hemorrhage. Key words: Hypertension; Cerebral hemorrhage; Surgical operation; The prognosis; Influence factors

Spontaneous intracerebral hemorrhage (sICH) is one of the most dangerous cerebrovascular diseases, especially when in deep brain. The treatment of spontaneous deep supratentorial intracerebral hemorrhage is still controversial. We conducted a retrospective case-control study using propensity score matching to compare the efficacy of surgery and conservative treatment for patients with deep surpatentorial hemorrhage.We observed the outcomes of consecutive patients with spontaneous deep supratentorial hemorrhage retrospectively from December 2008 to July 2013. Clinical outcomes of surgery and conservative treatments were compared in patients with deep sICH using propensity score matching method. The primary outcome was neurological function status at 6 months post ictus. The second outcomes included mortality at 30 days and 6 months, and the incidence of complications. Subgroup analyses of 6-month outcome were conducted.Sixty-three (22.66%) of the 278 patients who received surgery had a favorable neurological function status at 6 months, whereas in the conservative group, 66 of 278 (23.74%) had the same result (P = 0.763). The 30-day mortality in the surgical group was 19.06%, whereas 30.58% in the conservative group (P = 0.002). There was significant difference in the mortality at 6 months after ictus as well (23.38% vs 36.33%, P = 0.001). The subgroup analyses showed significantly better outcomes for the surgical group when hematoma was >40 mL (13.33% vs 0%, P = 0.005) or complicated with intraventricular hemorrhage (16.67% vs 7.27%, P = 0.034). For complications, the risk of pulmonary infection, gastrointestinal hemorrhage, urinary infection, pulmonary embolus, and need for tracheostomy/long term ventilation in the surgical group was higher than the conservative group (31.29% vs 15.47%, P < 0.001; 6.83% vs 3.96%, P = 0.133; 2.88% vs 1.80%, P = 0.400; 1.80% vs 1.08%, P = 0.476; 32.73% vs 23.38%, P = 0.014).Surgery could reduce the short-term mortality as well as long-term mortality in patients with spontaneous deep supratentorial hemorrhage. Moreover, surgery might improve the functional outcome in patients with large hematoma or with IVH compared with conservative treatment. Surgery might be a beneficial choice for part of the patients with spontaneous deep supratentorial hemorrhage, but further detailed research is still needed.

IntroductionWe assessed the correlation between iron deposition and the change of gliocyte metabolism in healthy subjects’ basal ganglia region, by using 3D-enhanced susceptibility weighted angiography (ESWAN) and proton magnetic resonance spectroscopy (1H-MRS).Material and methodsSeventy-seven healthy volunteers (39 female and 38 male subjects; age range: 24–82 years old) were enrolled in the experiment including ESWAN and proton MRS sequences, consent for which was provided by themselves or their guardians. For each subject, the mean phase value gained by ESWAN was used to evaluate the iron deposition; choline/creatine (Cho/Cr) and mI/Cr ratios gained by 1H-MRS were used to evaluate gliocyte metabolism in the basal ganglia region of both sides. The paired t test was used to test the difference between the two sides of the basal ganglia region. Linear regression was performed to evaluate the relation between mean phase value and age. Pearson's correlation coefficient was calculated to analyze the relationship between the result of ESWAN and 1H-MRS.ResultsThere was no difference between the two sides of the basal ganglia region in the mean phase value and Cho/Cr. But in mI/Cr the mean phase value of each nucleus in bilateral basal ganglia decreased with increasing age. There are 16 r-values between the mean phase value and Cho/Cr and mI/Cr in bilateral basal ganglia region. And each of all p-values is less than 0.001 (p < 0.001).ConclusionsIron deposition in the bilateral basal ganglia is associated with the change of gliocyte metabolism with increasing age. Iron deposition in each nucleus of the basal ganglia region changes with age.

ObjectiveThe study aimed to compare the effectiveness of endoscopic surgery assisted by 3D-Slicer with traditional craniotomy for treating basal ganglia hypertensive intracerebral hemorrhage (HICH).MethodsA total of 133 individuals diagnosed with hypertensive intracerebral hemorrhage in the basal ganglia region underwent surgical intervention in the Department of Neurosurgery at Affiliated Changshu Hospital of Nantong University from January 2018 to June 2023. Based on the surgical approach, participants were categorized into two cohorts: 76 patients who underwent endoscopic procedures and 57 who received traditional craniotomy. Postoperative hematoma clearance rates were quantified through volumetric analysis using 3D-Slicer software. Additionally, intergroup analyses were conducted to evaluate differences in surgical duration, hemorrhage volume during operation, Glasgow Coma Scale assessments at postoperative day 7, length of hospital stay and modified Rankin Scale score 3 months after surgery.ResultsThere were no statistically significant differences in preoperative baseline characteristics between the endoscopy and craniotomy groups (p > 0.05). However, the endoscopy group demonstrated superior surgical and clinical outcomes compared to the craniotomy group. Specifically, the endoscopy group achieved a significantly higher hematoma evacuation rate (90.0% ± 3.9% vs. 82.8% ± 4.9%, p < 0.01), a shorter operative time (1.5 ± 0.8 h vs. 4.9 ± 1.6 h, p < 0.01), and significantly reduced intraoperative blood loss (91.9 ± 89.1 mL vs. 593.6 ± 592.3 mL, p < 0.01). Postoperatively, the endoscopy group exhibited better neurological function, as indicated by higher Glasgow Coma Scale (GCS) scores (10.5 ± 2.3 vs. 7.9 ± 3.4, p < 0.01), and a shorter hospital stay (10.6 ± 5.8 days vs. 13.4 ± 8.2 days, p < 0.05). Postoperative modified Rankin Scale (mRS) score at 3 months were significantly better in the endoscopy group (3.4 ± 1.4 vs. 4.3 ± 1.7, p < 0.01) than in the craniotomy group. Endoscopic surgery was associated with more favorable outcomes, including higher hematoma clearance, reduced surgical duration and blood loss, improved neurological recovery, and faster postoperative rehabilitation compared to craniotomy. Data are presented as mean ± SD.ConclusionsEndoscopic procedures demonstrate superior clinical outcomes compared with conventional craniotomy for managing hypertensive intracerebral hemorrhage in the basal ganglia region, potentially enhancing patient recovery. This minimally invasive technique represents an advanced therapeutic approach for such cases. As endoscopic technology continues to evolve, its application in neurosurgical practice is expected to expand significantly. However, further validation through prospective randomized controlled studies remains essential to establish its efficacy conclusively.Supplementary InformationThe online version contains supplementary material available at 10.1186/s12893-025-03276-y.

To compare the perioperative indexes and long-term effects of craniotomy and neuro-endoscopic hematoma removal in patients with hypertensive intracerebral hemorrhage (HICH) in the basal ganglia region. This study involved 128 patients with HICH in the basal ganglia region who were admitted to our hospital from February 2020 to June 2022. They were divided into 2 groups according to the random number table method. The craniotomy group (n = 70) underwent microsurgery with small bone window craniotomy with a side cleft, and the neuro-endoscopy group (n = 58) underwent small bone window neuro-endoscopic surgery. A 3-dimensional Slicer was used to calculate the hematoma volume and clearance rate and the postoperative brain tissue edema volume. The operation time, intraoperative blood loss, postoperative intracranial pressure, complications, mortality, and improvement in the modified Rankin scale score at 6 months postoperatively were compared between the two groups. The clearance rate was significantly higher in the neuro-endoscopy group than in the craniotomy group (94.16% ± 1.86% versus 90.87% ± 1.89%, P < 0.0001). The operation time was significantly lower in the neuro-endoscopy group than in the craniotomy group (89.9 ± 11.7 versus 203.7 ± 57.6min, P < 0.0001). Intraoperative blood loss was significantly higher in the craniotomy group (248.31 ± 94.65 versus 78.66 ± 28.96mL, P < 0.0001). The postoperative length of stay in the intensive care unit was 12.6 days in the neuro-endoscopy group and 14.0 days in the craniotomy group with no significant difference ( P = 0.196). Intracranial pressure monitoring showed no significant difference between the two groups on postoperative days 1 and 7. Intracranial pressure was significantly higher in the craniotomy group than in the neuro-endoscopy group on postoperative day 3 (15.1 ± 6.8 versus 12.5 ± 6.8mm Hg, P = 0.029). There was no significant difference in the mortality or outcome rate at 6 months postoperatively between the two groups. In patients with HICH in the basal ganglia region, neuro-endoscopy can significantly improve the hematoma clearance rate, reduce intraoperative hemorrhage and postoperative cerebral tissue edema, and improve surgical efficiency. However, the long-term prognosis of patients who undergo craniotomy through the lateral fissure is similar to that of patients who undergo neuro-endoscopic surgery.

The integrity of the corticospinal tract (CST) is significantly affected following basal ganglia haemorrhage. We aimed to assess the local features of CST and to effectively predict motor function by diffusion characteristics of CST in patients with motor injury following acute haemorrhage in the acute basal ganglia region. We recruited 37 patients with paresis of the lateral limbs caused by acute basal ganglia haemorrhage. Based on the automated fiber quantification method to track CST, assessed the character of each CST segment between the affected and contralateral sides, and correlated these with the Fugl–Meyer (FM) and Barthel Index (BI) scores at 6 months after onset. The fractional anisotropy (FA) values of the injured side of CST showed a significantly lower FA than the contralateral side along the tract profiles (p < 0.05, corrections for multiple comparisons). The FA values of each site at the internal capsule, closed corona radiata were positively correlated with the FM and BI score at 6 months after onset (p < 0.001, respectively). Our findings assessed the character of CST vividly in detail and dementated the primary sites of CST can predict the long-term outcome of motor function. This study may facilitate future clinical and cognitive studies of acute haemorrhage.

The two most common surgical interventions for spontaneous intracerebral hemorrhage in the basal ganglia of patients more than 65 years old are either minimally invasive puncture and drainage or craniotomy. This study aimed to compare the curative effects of these two procedures in such patients. A retrospective study of patients older than years with spontaneous intracerebral hemorrhage was conducted between January 2012 and December 2015. Of the 86 patients, 47 received minimally invasive puncture and drainage and 39 underwent craniotomy. One year after surgery no statistically significant difference was observed between the two groups with respect to: evacuation rate of the hematoma five days after the operation, volume of residual hematoma, occurrence of rebleeding, development of infectious meningitis, length of hospitalization, fatality, or Glasgow Outcome Scale and Barthel Index scores. However, the amount of blood loss during the procedure (P < 0.001), total cost of hospitalization (P = 0.004), and incidence of epilepsy (P = 0.045) were significantly higher for the craniotomy group than the minimally invasive puncture and drainage group. It was found that, in patients older than 65 years with basal ganglia hemorrhage, minimally invasive puncture and drainage is less invasive, more cost efficient and induces less bleeding during surgery than craniotomy.

ABSTRACTBackgroundThe susceptibility values of the basal ganglia reflect the health status of these nuclei. We aimed to explore the associations between various demographic characteristics, lifestyle factors, and biological factors that have the potential to contribute to magnetic susceptibility and investigate the comprehensive impact of these multiple factors on basal ganglia susceptibility values.MethodsWe included 25,980 participants from the UK Biobank. Linear regression analysis was employed to assess the relationship between basal ganglia susceptibility values and demographic characteristics (age, sex, ethnicity), lifestyle factors (tea consumption, coffee intake, smoking status, alcohol consumption, physical activity, insomnia status), and biological factors (C‐reactive protein, blood cell counts, anthropometric measures, blood pressure parameters).ResultsMultiple factors demonstrated significant associations with basal ganglia iron deposition. Among biological factors, C‐reactive protein showed significant positive correlations with susceptibility values in the caudate nucleus (β = 0.028, p < 0.001), globus pallidus (β = 0.046, p < 0.001), and substantia nigra (β = 0.031, p < 0.001). Waist circumference, another biological measure, had substantial positive effects on most basal ganglia regions (β = 0.115 in caudate, β = 0.122 in putamen, β = 0.058 in globus pallidus). Among lifestyle factors, current smoking status was significantly associated with increased susceptibility values across all four basal ganglia nuclei (β = 0.053–0.061, all p < 0.001). Tea consumption demonstrated dose‐dependent protective effects, with daily consumption of ≥ 4 cups showing significant negative associations with all basal ganglia regions (−0.032 to −0.093 standard deviations). Age demonstrated significant positive associations with most basal ganglia regions. Gender differences were observed in tea consumption effects, with females showing stronger protective benefits (5.59 vs. 1.50 years of equivalent “rejuvenation” effect for 0–3 cups daily).ConclusionsWe provide evidence for multiple demographic, lifestyle, and biological factors influencing brain iron deposition in healthy middle‐aged and elderly individuals. Systemic inflammation, smoking, and increased adiposity were associated with greater iron deposition, while tea consumption showed protective effects. These findings highlight potential targets for interventions aimed at maintaining brain health.Ethics approval and consent to participateThe UK Biobank protocol was approved by the NHS North West Multicentre Research Ethics Committee (21/NW/0157). All participants provided informed consent at recruitment, allowing for follow‐up using data linkage to health records.

Objective To investigate the therapeutic effect of CT-guided stereotactic minimal invasive drainage for little hypertensive cerebral hemorrhage of basal ganglia region. Methods One hundred and ten patients with little hypertensive cerebral hemorrhage of basal ganglia region which hospitalized in 251 hospital of PLA from January 2013 to December 2015 were selected, the amount of bleeding was 20-30 ml, divided into the operation treatment group and conservative treatment group according to the random number table method, 55 patients in each group. The operation treatment group was given CT-guided stereotactic minimal invasive and drainage treatment, after operation, poured urokinase into the hematoma to dissolved it. The conservative treatment group was given internal medicine treatment alone. Results The emptying time of hematoma of the operation treatment group [(5.40±0.87) d] was significantly shorter than the conservative treatment group[(22.07±2.79) d] (P=0.001). The average hospitalization days of the operation treatment group [(19.35±3.67) d] was significantly shorter than the conservative treatment group[(23.26±2.80) d](P<0.05). The ADL classification of the operation treatment group (81.82%) which six months after treatment was excelled than the conservative treatment group(58.18%)(P<0.05). Conclusion Thestereotactic minimal invasive and drainage for little hypertensive cerebral hemorrhage of basal ganglia region were effective, with little injury, shorter hospitalization, supernal security, which can relieved the stress to important nerval tissue and ease the progressive injury and promote rehabilitation of function in the early. Thestereotactic minimal invasive and drainage for little hypertensive cerebral hemorrhage of basal ganglia region is worthy for the clinical popularization and application. Key words: Cerebral hemorrhage; Hypertension; Basal ganglia region; Stereotaxis