To Do or not to Do the Good and Bad about Decompressive Craniectomy

Abstract

Decompressive craniectomy (DC), which was described more than a century earlier, is now gaining a resurgence but is mired in debate and controversy. It is used as a last resort to treat refractory intracranial hypertension. In this issue ‐‐‐, et al. did a meta‐analysis of randomized controlled trials of decompressive craniectomy in traumatic brain injury.[1] The meta‐analysis is largely based on two big trials DECRA and Rescue ICP.[2,3] The authors have also included a smaller study for meta‐analysis and a study on DC in children with TBI for readership. Though both DECRA and Rescue ICP trials were done to determine the outcome of DC in patients with severe traumatic brain injury (TBI), there were a lot of differences between them which makes collective conclusions difficult.