In recent years, the incidence of hypertensive encephalopathy hemorrhage in China has increased significantly, and hemorrhage in the basal ganglia of the brain accounts for 60% to 70%, of which hypertensive putaminal hematomas (HPH) are the most common, accounting for 51% to 55% of all intracerebral hemorrhages. The aim of surgical treatment for HPH is to remove the hematoma, lower the intracranial pressure, relieve or prevent life-threatening cerebral herniation, and allow the possibility of recovery of the compressed neurons. Surgical methods: corticostomy hematoma removal: a large frontotemporal parietal “? In two cases, the cerebral cortex was significantly depressed, and the bone flap was repositioned and fixed with titanium clips. The size of the incision was determined according to the need of the disease. The incision was separated from the root of the lateral fissure under the microscope and entered vertically, with cerebral cotton protecting the vessels on both sides. In 22 cases, the cerebral cortical depression was obvious, and the bone flap was repositioned and fixed with titanium clips. CONCLUSIONS: The selection of microsurgery via the lateral fissure-insula approach for the treatment of hypertensive shell nucleus hemorrhage in appropriate cases is a minimally invasive treatment method with mild injury, excellent efficacy, and good prognosis, which can better improve the quality of survival.