Evidence map›Paper›PMID 42006920›Full record

ArticleBrain & spine2026

The effectiveness of decompressive craniectomy size in traumatic brain injury; an international, observational, comparative effectiveness study.

Rick J G Vreeburg, Ranjit D Singh, John K Yue, Jeroen T J M van Dijck, Hugo F den Boogert, Jussi P Posti, Wouter A Moojen, Wilco C Peul, Andrew I R Maas, Godard C W de Ruiter and 2 more

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Brain & spine, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Article
  2. Article
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

12 authors.

Rick J G VreeburgUniversity Neurosurgical Center Holland, Leiden University Medical Center, Haaglanden Medical Center and Haga Teaching Hospital, Leiden and the Hague, the Netherlands.
Ranjit D SinghUniversity Neurosurgical Center Holland, Leiden University Medical Center, Haaglanden Medical Center and Haga Teaching Hospital, Leiden and the Hague, the Netherlands.
John K YueDepartment of Neurosurgery, University of California, San Francisco, San Francisco, CA, USA.
Jeroen T J M van DijckUniversity Neurosurgical Center Holland, Leiden University Medical Center, Haaglanden Medical Center and Haga Teaching Hospital, Leiden and the Hague, the Netherlands.
Hugo F den BoogertUniversity Neurosurgical Center Holland, Leiden University Medical Center, Haaglanden Medical Center and Haga Teaching Hospital, Leiden and the Hague, the Netherlands.
Jussi P PostiDepartment of Neurosurgery and Turku Brain Injury Center, Turku University Hospital and University of Turku, Turku, Finland.
Wouter A MoojenUniversity Neurosurgical Center Holland, Leiden University Medical Center, Haaglanden Medical Center and Haga Teaching Hospital, Leiden and the Hague, the Netherlands.
Wilco C PeulUniversity Neurosurgical Center Holland, Leiden University Medical Center, Haaglanden Medical Center and Haga Teaching Hospital, Leiden and the Hague, the Netherlands.
Andrew I R MaasDepartment of Neurosurgery, Antwerp University Hospital, Edegem, Belgium.
Godard C W de RuiterUniversity Neurosurgical Center Holland, Leiden University Medical Center, Haaglanden Medical Center and Haga Teaching Hospital, Leiden and the Hague, the Netherlands.
Thomas A van EssenUniversity Neurosurgical Center Holland, Leiden University Medical Center, Haaglanden Medical Center and Haga Teaching Hospital, Leiden and the Hague, the Netherlands.
CENTER-TBI participants and investigators

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Introduction: Guidelines recommend large decompressive craniectomies (DC) in traumatic brain injury (TBI), yet the optimal size remains debated. Real-world practice often differs from guideline recommendations and generalizability of prior evidence to a broader TBI population is uncertain. Research question: What is the comparative effectiveness of DC size on 12-month functional outcome in TBI? Material and methods: We selected participants enrolled in the CENTER-TBI diagnosed with TBI who received a hemicraniectomy. Effect of DC size on functional outcome was evaluated with random-effects logistic regression, associating center case-mix adjusted DC sizes to GOSE. Center preference was quantified with the median odds ratio (MOR). Results: Among 4509 patients enrolled in CENTER-TBI, 295 underwent a hemicraniectomy. DC size varied from 37 cm Discussion and conclusion: DC size varied widely across European centers. Recommended DC sizes were rarely reached, as were very small DC sizes. Larger versus smaller DC was associated with similar outcomes, however heterogeneity in DC indication may have attenuated observable treatment effects. Neurosurgeons may continue to prefer larger over smaller decompressions.

Indexed as

CENTER-TBIDecompressive craniectomyLargeSizeSmallTraumatic brain injury

Identifiers

PMID42006920
PMCPMC13090328

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

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.