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.