Disability and quality-of-life outcomes were similar for adults with traumatic acute subdural hematoma who underwent craniotomy or decompressive craniectomy, according to new research. In all, 450 patients – 228 who were randomized to craniotomy and 222 who were randomized to decompressive craniectomy – underwent evacuation of the acute subdural hematoma. All patients had a bone flap with an anteroposterior diameter of at least 11 cm; the median diameter of the bone flap was 13 cm. At 12 months, the common odds ratio for the differences across the Extended Glasgow Outcome Scale (GOSE) ratings was 0.85; similar results were recorded at 6 months. The mortality rates at 12 months were 30.2% and 32.2% in the craniotomy and craniectomy groups, respectively, while 2.3% and 2.8% of the two groups, respectively, were in a vegetative state. Additionally, 25.6% of the craniotomy group had a lower or upper good recovery (no injury-related problems) compared with 19.9% in the craniectomy group. Quality of life scores, as measured by the EuroQol Group 5-Dimension 5-Level questionnaire, were similar at 12 months. With a rate of 14.6% vs. 6.9%, more cranial surgery within two weeks of randomization was conducted in the craniotomy group than the craniectomy group; however, wound complications were less frequent in the craniotomy group, at 3.9% vs. 12.2% in the craniectomy group.