Surgical Versus Medical Management for Severe Pediatric Traumatic Brain Injury: A Systematic Review and Meta-Analysis

In children with severe TBI, DC does not appear to provide clear survival or functional advantages over MM and is significantly associated with longer intensive care unit and hospital stays. However, these findings should be interpreted with caution as the current literature mainly composed of small and heterogeneous retrospective studies. Further large, prospective, multicenter studies are needed to confirm these findings, refine surgical indications, and establish pediatric-specific management guidelines.