To summarize the experience of surgical treatment of recurrent hematoma after craniotomy for hypertensive basal ganglia cerebral hemorrhage.

From February 2013 to February 2019, 413 cases of hypertensive basal ganglia cerebral hemorrhage in Qianxi People's Hospital received emergency craniotomy for hematoma removal and decompression, and 22 cases of postoperative hematoma recurrence were retrospectively analyzed. All cases were received carefully intraoperative hemostasis, postoperative ICU admission, active monitoring of blood pressure, and maintaining of blood pressure below 150/100 mmHg. 22 cases displayed postoperative hematoma recurrence in the original hematoma cavity, about 30 to 50 ml. Patients with recurrence of hematoma were treated with craniotomy and percutaneous minimally invasive drainage. To evaluate the effect of operation, Glasgow coma scale (GCS) score was used for all patients with hematoma recurrence one month after operation, and the daily life ability grade was evaluated half a year after operation.

The prognosis of patients with recurrent hematoma after craniotomy by minimally invasive puncture was better than that of patients with recurrent hematoma after craniotomy for hypertensive basal ganglia hemorrhage. One month after the operation, there was one case with GCS score of 7 in 6 patients with craniotomy, one case with GCS score of 8, and four cases with GCS score of 9 and above; there was one case with GCS score of 7 was found in 16 patients with recurrent hematoma via frontal puncture, two cases with GCS score of 8, and 13 cases with GCS score of 9 and above. After six months of follow-up, of the 6 patients who underwent craniotomy again, there were four cases with Grade Ⅰ~Ⅱ, one case with Grade III, and one case with Grade Ⅳ~Ⅴ; Of the 16 patients with hematoma undergoing frontal localization, there were 12 cases with Grade Ⅰ~Ⅱ, two cases with Grade III, and one case with Grade Ⅳ~Ⅴ.

Minimally invasive puncture and drainage of hematoma through frontal localization is a beneficial supplement to the treatment of recurrence of hematoma in the original operation cavity after craniotomy for hypertensive basal ganglia intracerebral hemorrhage.