The Value of Decompressive Craniectomy in Traumatic Brain Injury



Intracranial hypertension and brain swelling are well recognised secondary insults following traumatic brain injury (TBI), which are associated with increased mortality and worse outcomes. Decompressive craniectomy refers to the practice of removing a large bone flap and opening the underlying dura. By “opening the box”, the intracranial pressure is lowered and the risk of herniation can be avoided, although not completely eliminated. This chapter aims to critically appraise the existing evidence base in order to define the role of decompressive craniectomy following TBI.


Neurosurgery Neurotrauma Decompression Cranioplasty 



Angelos Kolias and Peter Hutchinson are supported by the NIHR Global Health Research Group on Neurotrauma, which was commissioned by the NIHR using Official Development Assistance (ODA) funding (project 16/137/105). The views expressed in this publication are those of the authors and not necessarily those of the NHS, National Institute for Health Research or the Department of Health.

Conflicts of Interest

Angelos Kolias and Peter Hutchinson were involved as investigators with the RESCUEicp trial. All authors are involved as investigators with the RESCUE-ASDH trial.


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Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  1. 1.Division of Neurosurgery, Department of Clinical NeurosciencesAddenbrooke’s Hospital and University of CambridgeCambridgeUK
  2. 2.NIHR Global Health Research Group on Neurotrauma, University of CambridgeCambridgeUK
  3. 3.Department of NeurosurgeryUniversity Hospital of Larissa and University of ThessalyLarissaGreece

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