Evidence map›Paper›PMID 31134383›Full record

ReviewActa neurochirurgica2019

Consensus statement from the International Consensus Meeting on the Role of Decompressive Craniectomy in the Management of Traumatic Brain Injury : Consensus statement.

Peter J Hutchinson, Angelos G Kolias, Tamara Tajsic, Amos Adeleye, Abenezer Tirsit Aklilu, Tedy Apriawan, Abdul Hafid Bajamal, Ernest J Barthélemy, B Indira Devi, Dhananjaya Bhat and 41 more

Registry-linked trialOpen access · hybridAbstract readReviewConsensus Statement
PubMed Full text at PMC Publisher
In one paragraph

Review in Acta neurochirurgica, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT06776614 (A Comparative-effectiveness Study on Expansion Craniotomy Versus Decompressive Craniectomy for Surgical Management of Traumatic Brain Injury in Patients With Intracranial Compartment Syndrome), which is not on this map. Cited by 87 papers, 6 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
87citing papers in PubMed, 6 pooled it
18.0field-weighted citation impact, top 1% of its field
1 · What the graph read from 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.

2 · The registry

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.

NCT06776614 not yet recruitingnot on this mapstarted 2025, after this paper: background citation

A Comparative-effectiveness Study on Expansion Craniotomy Versus Decompressive Craniectomy for Surgical Management of Traumatic Brain Injury in Patients With Intracranial Compartment Syndrome

Typeobservational_patient_registrySponsorMeditech FoundationRan2025 to 2027Enrolled292ConditionsTraumatic Brain Injuries, Intracranial HypertensionArmsDecompressive Craniectomy, Expansion Craniotomy
3 · Its place in the literature

Who cites it

87 citing papers in PubMed, 6 syntheses or guidelines pooled it, 208 citations in OpenAlex.

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  12. Hinge craniotomy in pediatric traumatic brain injury: a narrative review and national survey among Mexican neurosurgeons.Child's nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery · 2026
    Review
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27 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

51 authors at 20 institutions in 20 countries.

Peter J HutchinsonDivision of Neurosurgery, Department of Clinical Neurosciences, Addenbrooke's Hospital and University of Cambridge, Cambridge Biomedical Campus, Cambridge, CB20QQ, UK. pjah2@cam.ac.uk.
Angelos G KoliasDivision of Neurosurgery, Department of Clinical Neurosciences, Addenbrooke's Hospital and University of Cambridge, Cambridge Biomedical Campus, Cambridge, CB20QQ, UK.
Tamara TajsicDivision of Neurosurgery, Department of Clinical Neurosciences, Addenbrooke's Hospital and University of Cambridge, Cambridge Biomedical Campus, Cambridge, CB20QQ, UK.
Amos AdeleyeDivision of Neurological Surgery, Department of Surgery, College of Medicine, University of Ibadan, Ibadan, Nigeria.
Abenezer Tirsit AkliluNeurosurgical Unit, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia.
Tedy ApriawanDepartment of Neurosurgery, Faculty of Medicine, Universitas Airlangga, Soetomo General Hospital, Surabaya, Indonesia.
Abdul Hafid BajamalDepartment of Neurosurgery, Faculty of Medicine, Universitas Airlangga, Soetomo General Hospital, Surabaya, Indonesia.
Ernest J BarthélemyProgram in Global Surgery and Social Change, Department of Global Health and Social Medicine, Harvard Medical School, Boston, MA, USA.
B Indira DeviDepartment of Neurosurgery, National Institute for Mental Health and Neurosciences, Bangalore, India.
Dhananjaya BhatDepartment of Neurosurgery, National Institute for Mental Health and Neurosciences, Bangalore, India.
Diederik BultersWessex Neurological Centre, University Hospital Southampton, Southampton, UK.
Randall ChesnutHarborview Medical Center, University of Washington, Seattle, WA, USA.
Giuseppe CiterioSchool of Medicine and Surgery, University of Milan-Bicocca, Milan, Italy.
D Jamie CooperAustralian and New Zealand Intensive Care Research Centre, Monash University, Melbourne, Victoria, Australia.
Marek CzosnykaDivision of Neurosurgery, Department of Clinical Neurosciences, Addenbrooke's Hospital and University of Cambridge, Cambridge Biomedical Campus, Cambridge, CB20QQ, UK.
Idara EdemDivision of Neurosurgery, Department of Surgery, The Ottawa Hospital, Ottawa, ON, Canada.
Nasser M F El-GhandourDepartment of Neurosurgery, Faculty of Medicine, Cairo University, Cairo, Egypt.
Anthony FigajiDivision of Neurosurgery and Neuroscience Institute, University of Cape Town, Cape Town, South Africa.
Kostas N FountasDepartment of Neurosurgery, University Hospital of Larissa and University of Thessaly, Larissa, Greece.
Clare GallagherDivision of Neurosurgery, Department of Clinical Neurosciences, University of Calgary, Calgary, Alberta, Canada.
Gregory W J HawrylukDepartment of Neurosurgery, University of Manitoba, Winnipeg, Manitoba, Canada.
Corrado IaccarinoDepartment of Neurosurgery, Azienda Ospedaliero Universitaria di Parma, Parma, Italy.
Mathew JosephDepartment of Neurosurgery, Christian Medical College, Vellore, India.
Tariq KhanDepartment of Neurosurgery, North West General Hospital and Research Center, Peshawar, Pakistan.
Tsegazeab LaekeNeurosurgical Unit, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia.
Oleg LevchenkoDepartment of Neurosurgery, Moscow State University of Medicine and Dentistry, Moscow, Russian Federation.
Baiyun LiuDepartment of Neurosurgery, Beijing Tiantan Medical Hospital, Capital Medical University, Beijing, China.
Weiming LiuDepartment of Neurosurgery, Beijing Tiantan Medical Hospital, Capital Medical University, Beijing, China.
Andrew MaasDepartment of Neurosurgery, Antwerp University Hospital and University of Antwerp, Antwerp, Belgium.
Geoffrey T ManleyDepartment of Neurological Surgery, University of California San Francisco, San Francisco, CA, USA.
Paul MansonDepartment of Plastic and Reconstructive Surgery, Johns Hopkins Hospital, Baltimore, MD, USA.
Anna T MazzeoAnesthesia and Intensive Care Unit, Department of Surgical Sciences, University of Torino, Torino, Italy.
David K MenonDivision of Anaesthesia, Addenbrooke's Hospital and University of Cambridge, Cambridge, UK.
Daniel B MichaelOakland University William Beaumont School of Medicine and Michigan Head & Spine Institute, Auburn Hills, MI, USA.
Susanne MuehlschlegelDepartments of Neurology, Anesthesia/Critical Care & Surgery, University of Massachusetts Medical School, Worcester, MA, USA.
David O OkonkwoDepartment of Neurosurgery, University of Pittsburgh Medical Center, Pittsburgh, PA, USA.
Kee B ParkGlobal Neurosurgery Initiative, Program in Global Surgery and Social Change, Department of Global Health and Social Medicine, Harvard Medical School, Boston, MA, USA.
Jeffrey V RosenfeldDepartment of Neurosurgery, Alfred Hospital, Melbourne, Australia.
Gail RosseauGeorge Washington University School of Medicine and Health Sciences, Washington, DC, USA.
Andres M RubianoINUB/MEDITECH Research Group, El Bosque University, Bogotá, Colombia.
Hamisi K ShabaniDepartment of Neurosurgery, Muhimbili Orthopedic-Neurosurgical Institute, Dar es Salaam, Tanzania.
Nino StocchettiDepartment of Physiopathology and Transplantation, Milan University, Milan, Italy.
Shelly D TimmonsDepartment of Neurological Surgery, Penn State University Milton S. Hershey Medical Center, Hershey, PA, USA.
Ivan TimofeevDivision of Neurosurgery, Department of Clinical Neurosciences, Addenbrooke's Hospital and University of Cambridge, Cambridge Biomedical Campus, Cambridge, CB20QQ, UK.
Chris UffDepartment of Neurosurgery, The Royal London Hospital, London, UK.
Jamie S UllmanDepartment of Neurosurgery, Hofstra North Shore-LIJ School of Medicine, Hempstead, NY, USA.
Alex ValadkaDepartment of Neurosurgery, Virginia Commonwealth University, Richmond, VA, USA.
Vicknes WaranNeurosurgery Division, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia.
Adam WellsDepartment of Neurosurgery, Royal Adelaide Hospital, University of Adelaide, Adelaide, South Australia, Australia.
Mark H WilsonImperial Neurotrauma Centre, Department of Surgery and Cancer, Imperial College, London, UK.
Franco ServadeiDepartment of Neurosurgery, Humanitas University and Research Hospital, Milan, Italy.
Addenbrooke's Hospital · GBAddis Ababa University · ETAirlangga University · IDBeijing Tian Tan Hospital · CNNational Institute of Mental Health and Neurosciences · INUniversity of Cambridge · GBAntwerp University Hospital · BEAustralian and New Zealand Intensive Care Society · AUAzienda Ospedaliera San Gerardo · ITCairo University · EGChristian Medical College & Hospital · INEssex Cardiothoracic Centre · GBGeorge Washington University · USHofstra University · USHumanitas University · ITImperial College London · GBJohns Hopkins Hospital · USMichigan Head and Spine Institute · USMoscow State University of Medicine and Dentistry · RUMuhimbili Orthopaedic Institute · TZ

Funding

Medical Research Council G0601025
6 · The paper itself

Abstract

backgroundTwo randomised trials assessing the effectiveness of decompressive craniectomy (DC) following traumatic brain injury (TBI) were published in recent years: DECRA in 2011 and RESCUEicp in 2016. As the results have generated debate amongst clinicians and researchers working in the field of TBI worldwide, it was felt necessary to provide general guidance on the use of DC following TBI and identify areas of ongoing uncertainty via a consensus-based approach.

methodsThe International Consensus Meeting on the Role of Decompressive Craniectomy in the Management of Traumatic Brain Injury took place in Cambridge, UK, on the 28th and 29th September 2017. The meeting was jointly organised by the World Federation of Neurosurgical Societies (WFNS), AO/Global Neuro and the NIHR Global Health Research Group on Neurotrauma. Discussions and voting were organised around six pre-specified themes: (1) primary DC for mass lesions, (2) secondary DC for intracranial hypertension, (3) peri-operative care, (4) surgical technique, (5) cranial reconstruction and (6) DC in low- and middle-income countries.

resultsThe invited participants discussed existing published evidence and proposed consensus statements. Statements required an agreement threshold of more than 70% by blinded voting for approval.

conclusionsIn this manuscript, we present the final consensus-based recommendations. We have also identified areas of uncertainty, where further research is required, including the role of primary DC, the role of hinge craniotomy and the optimal timing and material for skull reconstruction.

Indexed as

Brain Injuries, TraumaticConsensusDecompressive CraniectomyHumansIntracranial HypertensionCranioplastyDecompressionNeurosurgeryNeurotrauma

Identifiers

PMID31134383
PMCPMC6581926
OpenAlexW2947272988

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

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.