Decompressive craniectomy versus craniotomy for acute traumatic subdural hematoma: A systematic review
DOI:
https://doi.org/10.35381/s.v.v10i2.5261Keywords:
hematoma, subdural, acute, decompressive craniectomy, craniotomy, brain injuries, traumatic, (Source: DeCS).Abstract
In acute traumatic subdural hematoma, the surgeon must decide whether to replace the bone flap or leave it out. Objective: To analyze the effectiveness and safety of decompressive craniectomy compared with craniotomy in this injury. Method: Qualitative systematic review following PRISMA 2020 in PubMed/MEDLINE, Scopus, Web of Science and SciELO (2021–2026), with content analysis. Results: Thirteen studies were included, among them one randomized trial and one multicenter cohort. Functional recovery and mortality were comparable when both techniques were feasible; craniotomy required more reoperations and craniectomy caused more wound complications. Conclusions: Craniotomy may be the primary option when the brain is not swollen; craniectomy should be reserved for intraoperative swelling or refractory intracranial hypertension.
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