Bifrontal decompressive craniectomy in the management of head trauma

Retrospective analysis of 13 patients who had bifrontal decompressive craniectomy for the management of posttraumatic cerebral edema shows a significant decrease in expected mortality, but severe morbidity in the survivors. Only one patient returned to the pretrauma level of neurological function. No correlation could be found between the quality of survival and the neurological or operative findings. The need for more accurate prognostic criteria in the evaluation of severely head-injured patients is discussed.