Timing of cranioplasty after decompressive craniectomy and neurological recovery: A systematic review and meta-analysis.

Prior systematic reviews have been limited in scope and have not fully examined cognitive outcomes, ultra-early cranioplasty (< 45 days), or traumatic brain injury (traumatic brain injury)-specific effects.

Cranioplasty, regardless of timing, was associated with significant neurological improvement.

Cognitive recovery assessed by MMSE also favored early cranioplasty (SMD = 0.57 [0.34-0.79], I² = 0%).

In traumatic brain injury-only analyses, the effect remained significant (SMD = 0.74 [0.32-1.15], I² = 88.5%).