The outcomes of the two main treatments for acute subdural hematoma were examined in a multicenter trial spanning 11 nations and published in the New England Journal of Medicine.An acute subdural hematoma occurs when blood seeps into the space between the brain and the skull; a site only filtered cerebral spinal fluid should flow. To cure, medical professionals remove the clot by opening up the skull, alleviating pressure on the brain. What do you do with that piece of the excised skull, though?This was the question of their clinical trial, explained Peter Hutchinson, Professor of Neurosurgery at Cambridge and the trial’s Chief Investigator, “which technique is optimal for removing an acute subdural hematoma – a craniotomy (putting the bone back) or a decompressive craniectomy.