{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,7]],"date-time":"2026-05-07T11:22:56Z","timestamp":1778152976749,"version":"3.51.4"},"reference-count":43,"publisher":"Georg Thieme Verlag KG","issue":"02","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J Neurol Surg A Cent Eur Neurosurg"],"published-print":{"date-parts":[[2025,3]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>\n          Background\u2003This study aimed to compare the clinical outcomes of decompressive craniectomy (DC) and craniotomy in treating acute subdural hematoma (ASDH) to provide a more precise assessment of the procedures' outcomes.<\/jats:p><jats:p>\n          Methods\u2003We searched for relevant articles in PubMed, Web of Science, Embase, Scopus, and Cochrane till August 2023, including cohort studies and randomized controlled trials comparing craniotomy and DC for ASDH. The analysis was conducted using \u201cReview Manager\u201d software, using the risk ratio along with a 95% confidence interval (CI) for categorical data, whereas continuous data were analyzed using the mean difference (MD) and 95% CI.<\/jats:p><jats:p>\n          Results\u2003Our analysis included 13 studies with a total of 4,689 patients, of whom 1,910 (40.7%) underwent DC and 2,779 (59.3%) underwent craniotomy. The results revealed a statistically significant difference in favor of craniotomy concerning good recovery in delayed GOS (risk ratio [RR]\u2009=\u20091.42; 95% CI [1.12, 1.81]), postoperative mortality (RR\u2009=\u20090.81; 95% CI [0.71, 0.94]), mortality at last follow-up (RR\u2009=\u20090.75; 95% CI [0.62, 0.91]), and hospital stay (MD\u2009=\u2009\u20133.71; 95%CI [\u20135.82, \u20131.60]). A nonsignificant difference (RR\u2009=\u20091.06; 95% CI [0.52, 2.17]; p\u2009=\u20090.87) was found between the two interventions concerning seizures.<\/jats:p><jats:p>\n          Conclusion\u2003Despite craniotomy's favorable clinical outcomes and mortality rates, the significant baseline differences between DC and craniotomy make these data inconclusive. To establish solid evidence regarding the use of DC versus craniotomy in ASDH, it is necessary to conduct well-controlled randomized studies with large sample sizes.<\/jats:p>","DOI":"10.1055\/s-0044-1791539","type":"journal-article","created":{"date-parts":[[2024,10,8]],"date-time":"2024-10-08T23:43:35Z","timestamp":1728431015000},"page":"182-195","source":"Crossref","is-referenced-by-count":2,"title":["Craniotomy versus Decompressive Craniectomy in Acute Subdural Hematoma Management: A Systematic Review and Meta-Analysis"],"prefix":"10.1055","volume":"86","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4976-7814","authenticated-orcid":false,"given":"Mohammed Maan","family":"Al-Salihi","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery, School of Medicine and Public Health, University of Wisconsin, Madison, Wisconsin, United States"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maryam Sabah","family":"Al-Jebur","sequence":"additional","affiliation":[{"name":"College of Medicine, University of Baghdad, Baghdad, Iraq"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yezan","family":"Al-Salihi","sequence":"additional","affiliation":[{"name":"College of Medicine, University of Baghdad, Baghdad, Iraq"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Elias","family":"Dumour","sequence":"additional","affiliation":[{"name":"Department of Paediatric Neurosurgery, Bristol Royal Hospital for Children, University Hospitals Bristol and Weston NHS foundation Trust, Bristol, United Kingdom"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ahmed","family":"Saleh","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Hamad General Hospital, Doha, Qatar"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mhran","family":"Daie","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Hamad General Hospital, Doha, Qatar"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Firas","family":"Hammadi","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Hamad General Hospital, Doha, Qatar"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ali","family":"Ayyad","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Hamad General Hospital, Doha, Qatar"},{"name":"Department of Neurosurgery, Saarland University Hospital, Homburg, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"194","published-online":{"date-parts":[[2024,10,8]]},"reference":[{"issue":"02","key":"ref1","doi-asserted-by":"crossref","first-page":"110","DOI":"10.1080\/02688690050004525","article-title":"CT prognostic factors in acute subdural haematomas: the value of the \u201cworst\u201d CT scan","volume":"14","author":"F Servadei","year":"2000","journal-title":"Br J Neurosurg"},{"issue":"07","key":"ref2","doi-asserted-by":"crossref","first-page":"718","DOI":"10.1016\/j.jocn.2005.08.019","article-title":"Comparison of craniotomy and craniectomy in patients with acute subdural haematoma","volume":"13","author":"C Woertgen","year":"2006","journal-title":"J Clin Neurosci"},{"key":"ref3","volume-title":"Subdural Hematoma","author":"L KN Pierre","year":"2023"},{"issue":"11","key":"ref4","doi-asserted-by":"crossref","first-page":"887","DOI":"10.2176\/nmc.cr.2014-0204","article-title":"Surgical management of traumatic acute subdural hematoma in adults: a review","volume":"54","author":"H Karibe","year":"2014","journal-title":"Neurol Med Chir (Tokyo)"},{"issue":"03","key":"ref5","doi-asserted-by":"crossref","first-page":"456","DOI":"10.1007\/s12028-008-9082-y","article-title":"Decompressive craniectomy","volume":"8","author":"C M Schirmer","year":"2008","journal-title":"Neurocrit Care"},{"issue":"09","key":"ref6","doi-asserted-by":"crossref","first-page":"979","DOI":"10.3109\/02699052.2013.794974","article-title":"The current role of decompressive craniectomy in the management of neurological emergencies","volume":"27","author":"S Honeybul","year":"2013","journal-title":"Brain Inj"},{"issue":"02","key":"ref7","doi-asserted-by":"crossref","first-page":"292","DOI":"10.1007\/s12028-015-0144-7","article-title":"Complications associated with decompressive craniectomy: a systematic review","volume":"23","author":"D B Kurland","year":"2015","journal-title":"Neurocrit Care"},{"issue":"02","key":"ref8","doi-asserted-by":"crossref","first-page":"187","DOI":"10.3171\/jns.1999.90.2.0187","article-title":"Surgical decompression for traumatic brain swelling: indications and results","volume":"90","author":"W K Guerra","year":"1999","journal-title":"J Neurosurg"},{"issue":"04","key":"ref9","doi-asserted-by":"crossref","first-page":"469","DOI":"10.3171\/jns.2006.104.4.469","article-title":"Outcome following decompressive craniectomy for malignant swelling due to severe head injury","volume":"104","author":"B Aarabi","year":"2006","journal-title":"J Neurosurg"},{"issue":"01","key":"ref10","doi-asserted-by":"crossref","first-page":"59","DOI":"10.3171\/jns.2007.106.1.59","article-title":"Decompressive hemicraniectomy in malignant middle cerebral artery infarction: an analysis of long-term outcome and factors in patient selection","volume":"106","author":"A Pillai","year":"2007","journal-title":"J Neurosurg"},{"issue":"06","key":"ref11","doi-asserted-by":"crossref","first-page":"1050","DOI":"10.1097\/00005373-200106000-00013","article-title":"Safety and feasibility of craniectomy with duraplasty as the initial surgical intervention for severe traumatic brain injury","volume":"50","author":"W M Coplin","year":"2001","journal-title":"J Trauma"},{"issue":"04","key":"ref12","doi-asserted-by":"crossref","first-page":"213","DOI":"10.1016\/j.accpm.2016.06.012","article-title":"Postoperative complications after craniotomy for brain tumor surgery","volume":"36","author":"L Lonjaret","year":"2017","journal-title":"Anaesth Crit Care Pain Med"},{"issue":"09","key":"ref13","doi-asserted-by":"crossref","first-page":"1563","DOI":"10.1007\/s00701-012-1349-6","article-title":"Primary decompressive craniectomy for acute subdural haematomas: results of an international survey","volume":"154","author":"A G Kolias","year":"2012","journal-title":"Acta Neurochir (Wien)"},{"key":"ref14","doi-asserted-by":"crossref","first-page":"25","DOI":"10.1016\/j.wneu.2015.12.034","article-title":"Craniotomy versus craniectomy for acute traumatic subdural hematoma in the United States: a national retrospective cohort analysis","volume":"88","author":"B Rush","year":"2016","journal-title":"World Neurosurg"},{"issue":"03","key":"ref15","first-page":"S7","article-title":"Surgical management of acute epidural hematomas","volume":"58","author":"M R Bullock","year":"2006","journal-title":"Neurosurgery"},{"issue":"71","key":"ref16","doi-asserted-by":"crossref","first-page":"n71","DOI":"10.1136\/bmj.n71","article-title":"The PRISMA 2020 statement: an updated guideline for reporting systematic reviews","volume":"372","author":"M J Page","year":"2021","journal-title":"BMJ"},{"key":"ref17","doi-asserted-by":"crossref","first-page":"d5928","DOI":"10.1136\/bmj.d5928","article-title":"The Cochrane collaboration's tool for assessing risk of bias in randomised trials","volume":"343","author":"J PT Higgins","year":"2011","journal-title":"BMJ"},{"issue":"01","key":"ref19","doi-asserted-by":"crossref","first-page":"30","DOI":"10.1186\/s41984-023-00209-w","article-title":"Comparative study between the outcome of decompressive craniotomy versus craniectomy in the management of acute subdural hematoma","volume":"38","author":"H M Azouz","year":"2023","journal-title":"Egypt J Neurosurg"},{"issue":"24","key":"ref20","doi-asserted-by":"crossref","first-page":"2219","DOI":"10.1056\/NEJMoa2214172","article-title":"Decompressive craniectomy versus craniotomy for acute subdural hematoma","volume":"388","author":"P J Hutchinson","year":"2023","journal-title":"N Engl J Med"},{"key":"ref21","doi-asserted-by":"crossref","first-page":"569","DOI":"10.1016\/j.wneu.2015.10.045","article-title":"Surgery for acute subdural hematoma: replace or remove the bone flap?","volume":"88","author":"G Tsermoulas","year":"2016","journal-title":"World Neurosurg"},{"issue":"02","key":"ref22","doi-asserted-by":"crossref","first-page":"504","DOI":"10.3171\/2019.4.JNS182660","article-title":"In-hospital mortality and length of hospital stay with craniotomy versus craniectomy for acute subdural hemorrhage: a multicenter, propensity score-matched analysis","volume":"133","author":"K Shibahashi","year":"2019","journal-title":"J Neurosurg"},{"issue":"01","key":"ref23","doi-asserted-by":"crossref","first-page":"22","DOI":"10.13004\/kjnt.2016.12.1.22","article-title":"Craniotomy or decompressive craniectomy for acute subdural hematomas: surgical selection and clinical outcome","volume":"12","author":"Y S Kwon","year":"2016","journal-title":"Korean J Neurotrauma"},{"issue":"04","key":"ref24","doi-asserted-by":"crossref","first-page":"297","DOI":"10.1055\/s-0040-1701235","article-title":"Pulmonary complications and sepsis following severe acute subdural hematoma in patients who underwent craniotomy versus craniectomy: a propensity score matched analysis","volume":"81","author":"N Ahmed","year":"2020","journal-title":"J Neurol Surg A Cent Eur Neurosurg"},{"issue":"06","key":"ref25","first-page":"1632","article-title":"Comparison of craniotomy and decompressive craniectomy in severely head-injured patients with acute subdural hematoma","volume":"71","author":"S H Chen","year":"2011","journal-title":"J Trauma"},{"issue":"03","key":"ref26","doi-asserted-by":"crossref","first-page":"347","DOI":"10.1177\/0003134820951463","article-title":"Mortality outcome of emergency decompressive craniectomy and craniotomy in the management of acute subdural hematoma: a national data analysis","volume":"87","author":"N Ahmed","year":"2021","journal-title":"Am Surg"},{"issue":"01","key":"ref27","doi-asserted-by":"crossref","first-page":"22","DOI":"10.23736\/S0390-5616.18.04502-2","article-title":"Surgical management of acute subdural hematoma: a comparison between decompressive craniectomy and craniotomy on patients treated from 2010 to the present in a single center","volume":"66","author":"A G Ruggeri","year":"2022","journal-title":"J Neurosurg Sci"},{"issue":"09","key":"ref28","doi-asserted-by":"crossref","first-page":"1555","DOI":"10.1007\/s00701-012-1428-8","article-title":"Outcome following evacuation of acute subdural haematomas: a comparison of craniotomy with decompressive craniectomy","volume":"154","author":"L M Li","year":"2012","journal-title":"Acta Neurochir (Wien)"},{"issue":"04","key":"ref29","doi-asserted-by":"crossref","first-page":"563","DOI":"10.1055\/s-0042-1758842","article-title":"Craniotomy or craniectomy for acute subdural hematoma? Difference in patient characteristics and outcomes at a tertiary care hospital","volume":"17","author":"S B Anis","year":"2022","journal-title":"Asian J Neurosurg"},{"key":"ref30","doi-asserted-by":"crossref","first-page":"677","DOI":"10.1016\/j.wneu.2017.03.024","article-title":"Craniotomy versus decompressive craniectomy for acute subdural hematoma: systematic review and meta-analysis","volume":"101","author":"K Phan","year":"2017","journal-title":"World Neurosurg"},{"key":"ref31","doi-asserted-by":"crossref","first-page":"137","DOI":"10.3889\/oamjms.2020.4282","article-title":"Comparison of clinical outcome between craniectomy and craniotomy as surgical management of traumatic acute subdural hematoma: a systematic review and meta-analysis","volume":"8","author":"T GB Mahadewa","year":"2020","journal-title":"Open Access Maced J Med Sci"},{"issue":"05","key":"ref32","doi-asserted-by":"crossref","first-page":"410","DOI":"10.3340\/jkns.2014.56.5.410","article-title":"Clinical analysis of epidural fluid collection as a complication after cranioplasty","volume":"56","author":"S P Kim","year":"2014","journal-title":"J Korean Neurosurg Soc"},{"issue":"01","key":"ref33","doi-asserted-by":"crossref","first-page":"182","DOI":"10.3171\/2014.9.JNS14405","article-title":"Complications following cranioplasty: incidence and predictors in 348 cases","volume":"123","author":"M Zanaty","year":"2015","journal-title":"J Neurosurg"},{"issue":"08","key":"ref34","first-page":"255","article-title":"Age related outcome in acute subdural haematoma following traumatic head injury","volume":"102","author":"S Hanif","year":"2009","journal-title":"Ir Med J"},{"key":"ref35","first-page":"281","article-title":"Outcome after acute traumatic subdural and epidural haematoma in Switzerland: a single-centre experience","volume":"138","author":"P Taussky","year":"2008","journal-title":"Swiss Med Wkly"},{"issue":"04","key":"ref36","doi-asserted-by":"crossref","first-page":"811","DOI":"10.1227\/NEU.0b013e318235d640","article-title":"Prognostic value of major extracranial injury in traumatic brain injury: an individual patient data meta-analysis in 39,274 patients","volume":"70","author":"N van Leeuwen","year":"2012","journal-title":"Neurosurgery"},{"issue":"01","key":"ref37","doi-asserted-by":"crossref","first-page":"36","DOI":"10.1097\/00005373-199507000-00005","article-title":"Prognostic factors after acute subdural hematoma","volume":"39","author":"D L Dent","year":"1995","journal-title":"J Trauma"},{"issue":"02","key":"ref38","doi-asserted-by":"crossref","first-page":"212","DOI":"10.3171\/jns.1991.74.2.0212","article-title":"Acute subdural hematoma: morbidity, mortality, and operative timing","volume":"74","author":"J E Wilberger Jr","year":"1991","journal-title":"J Neurosurg"},{"issue":"03","key":"ref39","doi-asserted-by":"crossref","first-page":"227","DOI":"10.3109\/02688699209002930","article-title":"The outcome from acute subdural and epidural intracranial haematomas in very elderly patients","volume":"6","author":"B Cagetti","year":"1992","journal-title":"Br J Neurosurg"},{"issue":"25","key":"ref40","doi-asserted-by":"crossref","first-page":"1511","DOI":"10.1056\/NEJM198106183042503","article-title":"Traumatic acute subdural hematoma: major mortality reduction in comatose patients treated within four hours","volume":"304","author":"J M Seelig","year":"1981","journal-title":"N Engl J Med"},{"key":"ref41","doi-asserted-by":"crossref","first-page":"111","DOI":"10.1007\/BF01560563","article-title":"Prognosis after acute subdural or epidural haemorrhage","volume":"90","author":"K Haselsberger","year":"1988","journal-title":"Acta Neurochir (Wien)"},{"key":"ref42","doi-asserted-by":"crossref","first-page":"56","DOI":"10.1007\/BF01404948","article-title":"Head-injured adult patients with GCS of 3 on admission\u2013who have a chance to survive?","volume":"133","author":"Z Kotwica","year":"1995","journal-title":"Acta Neurochir (Wien)"},{"issue":"04","key":"ref43","doi-asserted-by":"crossref","first-page":"683","DOI":"10.3171\/2009.2.JNS08817","article-title":"Outcome in patients with blunt head trauma and a Glasgow Coma Scale score of 3 at presentation","volume":"111","author":"R B Chamoun","year":"2009","journal-title":"J Neurosurg"},{"key":"ref44","doi-asserted-by":"crossref","first-page":"335","DOI":"10.1016\/j.wneu.2017.02.010","article-title":"The association of surgical method with outcomes of acute subdural hematoma patients: experience with 643 consecutive patients","volume":"101","author":"R Vilcinis","year":"2017","journal-title":"World Neurosurg"}],"container-title":["Journal of Neurological Surgery Part A: Central European Neurosurgery"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/www.thieme-connect.de\/products\/ejournals\/pdf\/10.1055\/s-0044-1791539.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,2,21]],"date-time":"2025-02-21T23:41:59Z","timestamp":1740181319000},"score":1,"resource":{"primary":{"URL":"http:\/\/www.thieme-connect.de\/DOI\/DOI?10.1055\/s-0044-1791539"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,10,8]]},"references-count":43,"journal-issue":{"issue":"02","published-online":{"date-parts":[[2025,2,21]]},"published-print":{"date-parts":[[2025,3]]}},"URL":"https:\/\/doi.org\/10.1055\/s-0044-1791539","archive":["Portico","CLOCKSS"],"relation":{},"ISSN":["2193-6315","2193-6323"],"issn-type":[{"value":"2193-6315","type":"print"},{"value":"2193-6323","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,10,8]]}}}