Abstract: Objective: To investigate the perioperative strategy for treatment of cerebroventricular hemorrhage with casting with both the drainage of cerebroventricle and the purification of cerebrospinal fluid.Methods: Thirty-four patients underwent bilateral or unilateral external cerebroventricular drainage and the purification of cerebrospinal fluid.The urokinase of 10 000 or 20 000 units in(4 ml) normal saline was injected into the cerebroventricular system 4 to 6 hours after no fresh blood was found in the drainage tube.Results: Eleven died,6 had severe disability,3 moderate disability,and 14 good recovery.Conclusions: The mortality of patients with total cerebroventricular hemorrhage can be decreased by early external drainage,the enhanced management during drainage period and the prevention of complications in the perioperative period.