Table 2.
Details of inclusion/exclusion criteria, medical management, and surgical interventions in each study
| Study | Criteria | Medical | Surgical |
|---|---|---|---|
| Statham 1989 | CT evidence of TBC- no specific parameters | Not specified | ICH evacuation in one patient |
| Peterson 2011 | •GCS ≥ 10 on admission | Mannitol or 3% saline aiming for Na+ > 150 and Osm > 300 | Bifrontal decompressive craniectomy |
| •Total contusion volume > 30 cm3, and unilateral volume > 10 cm3 on CT day 2 post-injury | |||
| •No other intracranial traumatic lesions | |||
| Gao 2013 | •CT evidence of TBC- no specific parameters | Osmolar treatment- aiming for 300–320 Osm | Bifrontal decompressive craniectomy |
| •Exclude patients with EDH > 30cm3, SDH > 10 mm thick, midline shift > 5 mm, or any other mass lesions > 20cm3 | ICP monitoring in those with: | Bifrontal craniotomy | |
| •GCS < 8 | Removal of contusion | ||
| •GCS 9–12 and agitation requiring sedation | |||
| •CT signs of deterioration and GCS drop of > 2 | tissue in both | ||
| Dong 2012 | •CT evidence of TBC- no specific parameters | •ICP monitoring | Bifrontal decompressive craniectomy (if ICP > 25 mmHg after mannitol administration) Endoscope-assisted unilateral cerebral falx incision when: (i) unilateral frontal contusion with volume < 15 mL, (ii) angle of two frontal angulus of lateral ventricles more than 120° and effacement of basal cisterns, (iii) deteriorating consciousness with ICP > 25 mmHg |
| •Mannitol | |||
| Wu 2014 | •CT evidence of TBC- no specific parameters | Only post-operative care specified: | Bifrontal decompressive craniectomy |
| •Surgically managed by BDC | •Therapeutic temperature reduction | ||
| •ICP control | |||
| •Nutritional support | |||
| •Hyperbaric oxygen | |||
| Sarma 2015 | •CT evidence of TBC- no specific parameters | Hyperosmolar agents | Bifrontal decompressive craniectomy |
| •No other intracranial traumatic lesions | Bifrontal craniotomy + contusion evacuation | ||
| Unilateral contusion evacuation | |||
| •Surgical management only | |||
| Zhaofeng 2016 | •CT evidence of TBC- no specific parameters | •Mannitol | Modified bifrontal decompressive craniectomy |
| •Furosemide | |||
| •Anti-convulsant medications | |||
| •No evidence of multi-organ injury/dysfunction | |||
| •No other intracranial traumatic lesions | |||
| •GCS < 5 | |||
| •Surgical management only |