Our Experience of Transsylvian-Transinsular Microsurgical Approach to Hypertensive Putaminal Hematomas

Background There are different reports about operative methods for the treatment of hypertensive intracerebral hematomas. Our experience of transsylvian-transinsular microsurgical approach to hypertensive putaminal hematomas was analyzed. Methods A retrospective analysis was performed on 28 consecutive patients with hypertensive intracerebral hematomas who underwent surgical treatment at the Department of Neurosurgery, Renji Hospital, from January 2004 to December 2007. Results The transsylvian-transinsular approach to evacuate the hypertensive putaminal hematoma gains a good result. We believe it allows decompression of important deep-seated neurostructures with a more suitable angle and shorter distance from the cortex to the hematoma; allows easier access to vessels responsible for the bleeding, reducing the rate of rebleeding postoperatively; and avoids damage to the temporal or frontal cortex. Conclusions Transsylvian-transinsular approach for hypertensive putaminal hematoma is advocated.