Abstract: Objective To analyze the mechanism and risk factors of hematoma in remote region following intracranial tumor resection. Methods Medical records of 5 229 patients underwent intracranial tumor resection in our hospital from March 2009 to December 2016 were retrospectively analyzed.Take 25 cases with remote intracranial hemorrhage as the hematoma group, whose surgeries were assited by intraoperative CT (intraoperative computed tomography, iCT) or intraoperative MRI (intraoperative magnetic resonance imaging, iMR), and 50 cases of intracranial tumor resection without ocurrence of hematoma were selected as the control group.Tumor size, hydrocephalus, cerebral atrophy, diabetes, hypertension, pathological type, intraoperative blood loss, operating time, tumor location and other information of the two groups were analyzed by univariate and multivariate logistic regression analysis.The differences of prognosis were evaluated by Glasgow outcome scale (GOS) 3 months after operation. Results The occurrence rate of remote intracranial hematoma was 0.47% in the patients with craniocerebral operation.Univariate analysis showed that there were signi ficant differences in hydrocephalus, brain atrophy, tumor size, intraoperative blood loss and operating time between groups (P＜ 0.05, respectively).Multivariate logistic regression analysis showed that tumor size, hydrocephalus and brain atrophy were independent risk factors for remote intracranial hematoma in surgery for brain metastases (P＜ 0.05, respectively).There was no signi ficant difference of prognosis between hematoma group and control group (P＞ 0.05). Conclusion Tumor size, cerebral hydrocephalus, cerebral atrophy were listed as the risk factors of remote intracranial hematoma following intracranial tumor resection, which can be found on time by intraoperative CT and MRI and can be removed to greatly improve the prognosis.