Is decompressive craniectomy useless in severe traumatic brain injury?
Recently, a multicenter randomized controlled trial (RCT) by Cooper and colleagues indicated that decompressive craniectomy (DC) may be associated with a worse functional outcome in patients with diffuse traumatic brain injury (TBI), although DC can immediately and constantly reduce intracranial pressure (ICP). As this trial is well planned and of high quality, the unexpected result is meaningful. However, the evidence of the study is insufficient and the effect of DC in severe TBI is still uncertain. Additional multicenter RCTs are necessary to provide class I evidence on the role of DC in the treatment of refractory raised ICP after severe TBI.
Department of Neurosurgery, West China Hospital, Sichuan University, 37 Guoxuexiang Street, Chengdu 610041, The People's Republic of China.
Junpeng
J
Ma
Chao
C
You
Lu
L
Ma
Siqing
S
Huang
D001930:Brain Injuries / Q000473:pathology / Q000601:surgery*; D056424:Decompressive Craniectomy / Q000706:statistics & numerical data* / Q000639:trends; D006801:Humans; D015337:Multicenter Studies as Topic / Q000639:trends; D016032:Randomized Controlled Trials as Topic / Q000639:trends; D012720:Severity of Illness Index; D016896:Treatment Outcome