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Background: Traumatic interhemispheric subdural hematoma (TISH) is a rare clinical event.As early clinical presentation of TISH is non-characteristic, severe consequences may ensue if diagnosis is delayed or treatment is inappropriate.There is controversy over the management of TISH, and there are different reports about the outcome of TISH treatment.There are few studies reporting the outcome of surgical treatment of TISH in particular.The main purpose of the present study is to further improve the clinical outcome of TISH treatment.Methods: Clinical data, surgical modalities, and outcomes of 21 patients with TISH who were treated with mircrosurgery were analyzed retrospectively.Results: According to Glasgow coma scale (GCS), good recovery was found in 16 cases, moderate disability in two cases, severe disability in one case, vegetative survival in one cases, and death in one case during postoperative follow-up periods of 1-9 years.There were confirmed sources of hemorrhage in all 21 cases.Whole cerebral longitudinal fissure hematoma was more frequently seen in patients with hemorrhage from rupture of the distal anterior cerebral artery and veins in the cerebral longitudinal fissure, for which the prognosis of the surgical outcome was usually good.Local hematoma, laceration and edema in the cerebral longitudinal fissure were more frequently seen in patients with hemorrhage from brain tissue laceration of the longitudinal fissure, the prognosis of which was usually poor.Conclusion: A good understanding of surgical indications, a good command of surgical skills and timely surgical intervention are helpful in improving the prognosis of TISH patients.