Trial reportCritical care (London, England)2009
Effects of unilateral decompressive craniectomy on patients with unilateral acute post-traumatic brain swelling after severe traumatic brain injury.
Trial report in Critical care (London, England), 2009. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 49 papers, 7 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
49 citing papers in PubMed, 7 syntheses or guidelines pooled it, 155 citations in OpenAlex.
- Surgical intervention in traumatic brain injury: a systematic review and meta-analysis of decompressive craniotomy.European journal of trauma and emergency surgery : official publication of the European Trauma Society · 2025Pooled it
- A systematic review and meta-analysis of factors involved in bone flap resorption after decompressive craniectomy.Neurosurgical review · 2022Pooled it
- Guidelines for the Management of Severe Traumatic Brain Injury: 2020 Update of the Decompressive Craniectomy Recommendations.Neurosurgery · 2020Guideline
- Decompressive craniectomy for the treatment of high intracranial pressure in closed traumatic brain injury.The Cochrane database of systematic reviews · 2019Pooled it
- Decompressive craniectomy in the management of intracranial hypertension after traumatic brain injury: a systematic review and meta-analysis.Scientific reports · 2017Pooled it
- Complications Associated with Decompressive Craniectomy: A Systematic Review.Neurocritical care · 2015Pooled it
- Pooled it
- Decompressive craniectomy in adults with moderate to severe traumatic brain injury: A systematic review and meta-analysis of randomised controlled trials.Critical care and resuscitation : journal of the Australasian Academy of Critical Care Medicine · 2026Article
- Intracranial pressure management in severe intraventricular hemorrhage: A minireview.World journal of critical care medicine · 2026Review
- A systematic review of mortality and long-term functional outcomes after decompressive craniectomy for acquired brain injury: The missing rehabilitation reporting.AIMS neuroscience · 2026Review
- Primary versus secondary decompressive craniectomy in traumatic brain injury: analysis of the indications and outcomes.European journal of trauma and emergency surgery : official publication of the European Trauma Society · 2025Article
- Impact of Craniectomy Size on Outcomes in Traumatic Brain Injury: A Retrospective Study at Shohadaye-Haftome-Tir Hospital, Tehran, Iran (2019-2021).Medical journal of the Islamic Republic of Iran · 2025Article
- Decompressive Craniectomy and Hinged Craniotomy for Traumatic Brain Injury: Experience in Two Centers in a Middle-Income Country.Korean journal of neurotrauma · 2024Article
- Intracranial pressure changes in traumatic brain injury patients undergoing unilateral decompressive craniectomy with dural expansion.World neurosurgery: X · 2024Article
- Indications and scientific support for supratentorial unilateral decompressive craniectomy for different subgroups of patients: A scoping review.Acta neurochirurgica · 2024Article
- Practical pearls for management of cranial injury in the developing world.Neurosurgical review · 2024Review
- Decompressive craniectomy: A primer for acute care practitioners.Journal of the Intensive Care Society · 2024Review
- Incidence, risk factors, and clinical outcomes of acute brain swelling associated with traumatic acute subdural hematoma: a retrospective study utilizing novel diagnostic criteria.Therapeutic advances in neurological disorders · 2024Article
- Size of Craniectomy Predicts Approach-Related Shear Bleeding in Poor-Grade Subarachnoid Hemorrhage.Brain sciences · 2023Article
- Decompressive Craniectomy in Severe Traumatic Brain Injury: The Intensivist's Point of View.Diseases (Basel, Switzerland) · 2023Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
10 authors at 3 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
introductionAcute post-traumatic brain swelling (BS) is one of the pathological forms that need emergent treatment following traumatic brain injury. There is controversy about the effects of craniotomy on acute post-traumatic BS. The aim of the present clinical study was to assess the efficacy of unilateral decompressive craniectomy (DC) or unilateral routine temporoparietal craniectomy on patients with unilateral acute post-traumatic BS.
methodsSeventy-four patients of unilateral acute post-traumatic BS with midline shifting more than 5 mm were divided randomly into two groups: unilateral DC group (n = 37) and unilateral routine temporoparietal craniectomy group (control group, n = 37). The vital signs, the intracranial pressure (ICP), the Glasgow outcome scale (GOS), the mortality rate and the complications were prospectively analysed.
resultsThe mean ICP values of patients in the unilateral DC group at hour 24, hour 48, hour 72 and hour 96 after injury were much lower than those of the control group (15.19 +/- 2.18 mmHg, 16.53 +/- 1.53 mmHg, 15.98 +/- 2.24 mmHg and 13.518 +/- 2.33 mmHg versus 19.95 +/- 2.24 mmHg, 18.32 +/- 1.77 mmHg, 21.05 +/- 2.23 mmHg and 17.68 +/- 1.40 mmHg, respectively). The mortality rates at 1 month after treatment were 27% in the unilateral DC group and 57% in the control group (p = 0.010). Good neurological outcome (GOS Score of 4 to 5) rates 1 year after injury for the groups were 56.8% and 32.4%, respectively (p = 0.035). The incidences of delayed intracranial hematoma and subdural effusion were 21.6% and 10.8% versus 5.4% and 0, respectively (p = 0.041 and 0.040).
conclusionsOur data suggest that unilateral DC has superiority in lowering ICP, reducing the mortality rate and improving neurological outcomes over unilateral routine temporoparietal craniectomy. However, it increases the incidence of delayed intracranial hematomas and subdural effusion, some of which need secondary surgical intervention. These results provide information important for further large and multicenter clinical trials on the effects of DC in patients with acute post-traumatic BS.
trial registrationISRCTN14110527.
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.