Objective:　This　study　aimed　to　introduce　an　effective　treatment　for　intractable　contralateral　subdural　effusion　after　standard　decompressive　craniectomy　in　patients　with　severe　traumatic　brain　injury　(TBI)　and　to　analyze　the　underlying　mechanism.　Methods:　A　retrospective　analysis　was　performed　in　13　patients　with　severe　traumatic　craniocerebral　injury　showing　complicated　intractable　contralateral　subdural　effusion　after　standard　decompressive　craniectomy,　in　whom　satisfactory　results　were　not　obtained　from　treatments,　including　compression　bandaging,　head-down　bed　rest　(HDBR),　continuing　lumbar　drainage,　and　Ommaya　catheter　drainage.　Among　these　patients,　6　underwent　temporal　muscle　sticking,　while　7　underwent　early　cranioplasty.　The　postoperative　changes　in　the　subdural　effusion　were　observed.　Results:　In　the　6　patients　who　underwent　temporal　muscle　sticking　and　the　7　who　underwent　early　cranioplasty,　the　subdural　effusion　completely　resolved　or　was　significantly　reduced　within　one　month,　and　no　recurrence　was　observed　in　the　6-month　follow-up　period.　However,　secondary　bilateral　cranioplasty　was　still　necessary　in　the　postoperative　3-6　months　for　the　patients　who　underwent　temporal　muscle　sticking.　In　the　early　cranioplasty　group,　there　were　three　total　operations,　and　the　average　length　of　stay　(ALOS)　was　76　days.　In　the　temporal　muscle　sticking　group,　there　were　four　total　operations,　and　the　ALOS　was　56.1　days.　A　retrospective　analysis　of　surgical　pain　showed　that　100%　of　the　patients　in　the　first　group　experienced　unacceptable　suffering,　while　14.3%　of　the　patients　in　the　second　group　experienced　pain.　Conclusion:　Early　cranioplasty　is　an　effective,　economical,　and　less　painful　treatment　for　intractable　contralateral　subdural　effusion　after　standard　decompressive　craniectomy.　(C)　2016　Elsevier　B.V.　All　rights　reserved.