... presented pilot trialadds an additional argument for surgical decompression atan early stage in case of treatment -refractory intracranial hypertension, and calls for a controlled trial that includes ... controlled, randomized study to evaluate the indica-tion and standardization of early decompressive craniectomy as a ‘second tier’ standard therapy in children with severehead injury.Competing interestsNone ... 21:758-764.26. Munar F, Ferrer AM, de Nadal M, Poca MA, Pedraza S, SahuquilloJ, Garnacho A: Cerebral hemodynamic effects of 7.2% hyper-tonic saline in patients with head injury and raised intracranial pressure....