Background and objectives Acute subdural hematoma (aSDH) after traumatic brain injury
frequently requires emergent craniotomy (CO) or decompressive craniectomy (DC). We
sought to determine the variables associated with either surgical approach and to compare
outcomes between matched patients. Methods A multi-center retrospective review was used
to identify traumatic aSDH patients who underwent CO or DC. Patient variables
independently associated with surgical approach were used for coarsened exact matching …

METHODS: One hundred thirty-eight patients underwent CO (N= 76) or DC (N= 62) for
traumatic aSDH. DC patients were on average 21.4 years younger (P< 0.001), more likely to
be male (80.6% vs 60.5%, P= 0.011), and present with GCS= 8 (64.5% vs 36.8%, P= 0.001).
Age (P< 0.001), EDH (P= 0.01), skull fracture (P= 0.001), and cisternal effacement (P= 0.02)
were independently associated with surgical approach. After coarsened exact matching, DC
(P= 0.008), older age (P= 0.007), male sex (P= 0.04), and IVH (P= 0.02), were independently …