【Abstract】 Objective To explore the inflammatory expression and therapeutic effect in keyhole craniotomy hematoma clearance treating primary intraventricular hemorrhage.Methods 68 patients of intraventricular hemorrhage in my department from January 2011 to December 2015 were divided into experiment group and control group, depending on the operation style. The control group was operated through Frontal transcortical approach. The experiment group was operated through keyhole craniotomy hematoma clearance. The inflammatory factor and the therapeutic effect were observed. Results TNFa expressions reduced after the operation. 3d after operation, TNFa expression in experimental group wass better than that in control group (P＜005). CRP xpressions reduced after the operation. 3d and 1W after operation, CRP expression in experimental group was better than that in control group (P＜005). Intracranial hemorrhage, Pulmonary infection and Uranary tract infection between the two group had no defferencev(P＞005). Hydrocephalus in experiment group was better than that in control group (P＜005). The Duration of drainage tube, Incidence of intracranial infection, Recovery time of consciousness and ICU hospitalized daysbetween the two groups have no defference (P＞005). GOS between the two groups has no defference (P＞005).Conclusion Intraventricular hemorrhage is the mysterious illness which has bad prognosis. The operation style should depend on the patients’specific situation and the family’will.