Outcome of Decompressive Craniectomy in Patients With Severe Head Injury: A Pilot Randomized Clinical Trial

Background: Head injury is the most important cause of death caused by trauma. Decompressive craniectomy is the best-known way to reduce otherwise intractable intracranial pressure and its complications in traumatic brain injury. Aim: This aim of this study was to evaluate the outcome of patients with decompressive craniectomy after severe traumatic brain injury and compare with a control group. Setting: Al-Zahra and Kashani hospital in Isfahan. Design: Pilot randomized clinical trial. Methods: Twenty patients were entered in this study. Patients were randomly divided into group A and group B. Group A received surgical and conservative treatment and group B underwent conservative treatment alone. Both groups were then followed for 6 months. Both groups' presentation Glasgow Coma Scale and Glasgow Outcome Scale (GOS) were compared. Results: A favorable GOS was achieved in 6 cases (60%) of patients in group A and in 2 cases (20%) in group B. However, the difference was not statistically significant. The death rate was higher in group B, with 3 cases (30%), and only 1 patient (10%) died in group A, but the difference was not significant. Conclusions: Decompressive craniectomy seems to be helpful and may lead to a better GOS achievement and improve the mortality rate among traumatic brain injury patients; however, further investigation will be needed to confirm the results.