Decompressive craniectomy in neurocritical care

•Decompressive craniectomy (DC) significantly reduces the risk of death in malignant middle cerebral artery infarction (MCAI).•DC does not reduce the risk of death in severe traumatic brain injury (TBI).•The composite risk of death or dependence is not reduced in either MACI or TBI.•Randomized controlled trials on TBI are uncommon and further trials are needed.