To compare the levels of serum tumor necrosis factor alpha (TNF-α), S100β, neuron specific enolase (NSE) and GCS score in patients with hypertensive intracerebral hemorrhage after craniotomy and drainage and to compare the effects of two methods on brain injury.

Forty-six cases of hypertensive cerebral hemorrhage in The First Hospital of Shanxi Medical University were divided into drilling group (22 cases) and craniotomy group (24 cases), and the control group were 20 healthy persons for physical examination in the same period. The serum levels of TNF-α, S100β, NSE and GCS score were measured at 1^st, 3^rd, 7^th and 14^th days after operation in the drilling and craniotomy groups, and the serum levels of TNF-α, S100β, NSE in the control group were measured. The serum levels of TNF-α, S100β, NSE and GCS score were compared between the drilling group and the craniotomy group at 1^st, 3^rd, 7^th and 14^th days after operation and the control group.

The serum TNF-α, S100β, NSE in the drilling group and the craniotomy group were higher than the normal level at the early postoperative period, and they both peaked at the beginning and then gradually decreased (TNF-α: F=38.629, P=0.000; S100β: F=33.381, P=0.000; NSE: F=25.619, P=0.000). The GCS scores of the 2 groups were lower on the 1^st to 7^th days after operation, and they both increased on the 14^th day after operation and were still lower than normal levels (F=11.569, P=0.000). At 1^st, 3^rd, 7^th and 14^th days after operation serum TNF-α, S100β, NSE and GCS scores in the drilling group and the craniotomy group were not statistically different (P>0.962).

There was no difference in the effect of craniotomy and drainage on the serum levels of TNF-α, S100β, NSE and GCS scores in patients with hypertensive intracerebral hemorrhage. There is no difference in the effect of the two programs on brain injury. Craniotomy hematoma removal can not easily be considered less effective than drilling and drainage, and two kinds of surgery have their own advantages and disadvantages. Clinical applications need to be flexible according to different situations.