Abstract: [Abstract]  Objective To investigate the efficacy of minimally invasive intracranial hematoma puncture and drainage in the treatment of hypertensive intracerebral hemorrhage（HICH）at different operation opportunities and its influence on the serum levels of neuronspecific enolase（NSE），brainderived neurotrophic factor（BDNF）and homocysteine（Hcy）.Methods The clinical data of 200 patients with HICH who treated with minimally invasive intracranial hematoma puncture and drainage were retrospectively analyzed.The patients were divided into four groups according to the time of operation：23 cases as ultraearly group（<6h），52 cases as early group（6～12h），96 cases as midterm group（>12～24h）and 29 cases as delayed group（>24h）.The rate of postoperative rebleeding and the shortterm prognosis were compared among the four groups，the scores of National Institutes of Health Stroke Scale（NIHSS）was evaluated，the changes of serum NSE，BDNF and Hcy levels were determined.Results The complete hematoma clearance rate and good prognosis rate in the ultraearly group and the early group were significantly higher than those in the midterm group and deferred group（P<0.05）.The rebleeding rate in the ultraearly group was significantly higher than that in the other three groups（P<0.05）.After surgery，the serum levels of NSE and Hcy were significantly lower than the midterm and delayed groups，while the BDNF was significantly higher than the two groups（P<0.05）.Conclusion The optimal operation window of minimally invasive intracranial hematoma puncture and drainage for HICH is 12 hours after HICH.The earlier operation is more conducive to gain better clinical prognosis and can protect the cerebral nerve function，its mechanism may be related to the regulation of NSE，BDNF and Hcy levels.

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