Depending on the location of the affected area, different surgical decompression techniques have been developed. In the presence of diffuse brain edema without a midline shift, as commonly seen in traumatic brain injury, bilateral (eg, bifrontal) craniectomy has been advocated. Hemicraniectomy, or removal of a frontotemporoparietal bone flap, is suitable in patients with unilateral hemisphere swelling as seen after ischemic stroke 1).
Accumulating experience over the years has led to increasing refinement of the surgical technique. The size of the removed bone fragment has been recognized as a factor of crucial importance for the generation of a sufficient decompressive effect 2).
see Hemicraniectomy- Unilateral decompressive craniectomy
see Bifrontal decompressive craniectomy