To investigate the hematoma emptying effect of stereotaxic transfrontal and suboccipital surgical methods in the treatment of brainstem hemorrhage.

Twenty-four patients with brainstem hemorrhage who underwent surgical treatment in Neurosurgery Department of Dongguan People's Hospital from September 2019 to June 2022 were selected and divided into frontal group (15 cases) and suboccipital group (9 cases) according to the operation type. The intraoperative amount of hematoma broken and sucked out residual hematoma after operation, residual hematoma after drainage, depth of brain tissue puncture during operation, number of urokinase washings in hematoma cavity after operation, and retention time of drainage tube were recorded and compared between the two groups.

The amount of blood-sucking hematoma in the frontal group was less than in the suboccipital group, and the depth of puncture brain tissue was significantly deeper than that in the suboccipital group, the difference was statistically significant (P<0.05); There was no significant difference between the two groups in the residual amount of hematoma after operation, the residual amount of hematoma after drainage, the number of postoperative urokinase washings, and the retention time of drainage tube (P>0.05).

Although the transfrontal group is more difficult to break and suck out the hematoma during operation, the final drainage effect after catheter and drainage is basically the same as that of the suboccipital group. The transfrontal approach is suitable for hematoma located above the level of the pons and midbrain, and the suboccipital approach is suitable for hematoma located in the posterior part of the pons and broken into the fourth ventricle and cerebellum.