What does this research mean for the field?

Bifrontal decompressive craniectomy may offer a survival benefit for patients with otherwise-fatal elevations in intracranial pressure, though functional outcomes vary widely and the risk of severe disability remains substantial. Novelty: ClaimNovelty.SYNTHESIS. Consensus alignment: ConsensusAlignment.NEUTRAL.

What question did this study set out to answer?

To assess the clinical efficacy, indications, and functional outcomes of bifrontal decompressive craniectomy for refractory intracranial pressure across diverse acute brain pathologies.

September 14, 2026Surgical Neurology International

Reappraising the bifrontal decompressive craniectomy: A systematic literature review of indications, outcomes, and clinical applications

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To assess the clinical efficacy, indications, and functional outcomes of bifrontal decompressive craniectomy for refractory intracranial pressure across diverse acute brain pathologies.
Systematically searched MEDLINE, PubMed, Scopus, Embase, and Cochrane databases for studies reporting bifrontal decompressive craniectomy outcomes.
Extracted clinical and functional data across 54 qualifying studies comprising 742 patients, complemented by anatomical dissections of 3 cadaveric heads.
Traumatic brain injury was the primary surgical etiology in 88.4% of cases (656/742), with 60.7% of evaluated patients (315/519) presenting with a Glasgow Coma Scale score ≤8.
Mean time from initial injury to craniectomy was 2.5 ± 1.9 days, followed by a mean intensive care unit stay of 12.9 ± 5.0 days and a hospital stay of 66.7 ± 38.9 days.
Among 494 patients with documented Glasgow Outcome Scale scores, 205 achieved score 5 (good recovery), 75 scored 4, 71 scored 3, 24 scored 2, and 119 scored 1 (mortality).

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Implication

Systematic review reveals variable functional recovery despite survival gains after bifrontal decompressive craniectomy, highlighting the need for careful patient selection.

Cite This Study

Olson et al. (2026) studied this question.

synapsesocial.com/papers/6aa7b2e10926e14a848b16c8 https://doi.org/10.25259/sni_812_2026

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Implication

Systematic review reveals variable functional recovery despite survival gains after bifrontal decompressive craniectomy, highlighting the need for careful patient selection.

Reappraising the bifrontal decompressive craniectomy: A systematic literature review of indications, outcomes, and clinical applications

Key Points

Discussion

Implication

Cite This Study

Reappraising the bifrontal decompressive craniectomy: A systematic literature review of indications, outcomes, and clinical applications

Key Points

Discussion

Implication

Cite This Study