The Columbia University Medical Center Department of Neurological Surgery faculty will lead you through a bilateral frontotemporal decompressive craniectomy. A 27 year-old male with no medical history presents with a GCS of 3 immediately after a high speed motorcycle accident. A head CT showed bilateral contusions and an ICP parenchymal monitor was placed. A repeat head CT showed diffuse cerebral edema and blossoming contusions. Presented by Ricardo Komotar, MD; Christopher Kellner, MD; Marc Otten, MD; E. Sander Connolly Jr., MD; and Guy McKahnn, II, MD.