The patient is a 31-year-old female, 3 months ago, after a car accident resulting in severe craniocerebral trauma, in a tertiary hospital in the province for surgical treatment, postoperative persistent coma, and left a large right skull defect, mild hydrocephalus, seriously affecting the patient’s late recovery. The neurosurgical team led by Professor Yan Changxiang after full communication and strict argumentation that if the skull repair and cerebrospinal fluid ventriculoperitoneal shunt is performed at the same time may cause brain tissue collapse, resulting in intracranial hemorrhage, so decided to repair the defective skull first, and be prepared for intraoperative puncture and drainage due to the aggravation of hydrocephalus. The operation went on as scheduled and successfully overcame difficulties such as severe adhesions between brain tissue and dura mater and thin scalp. On the second day after surgery, the patient recovered consciousness, could answer correctly, and the limb movement gradually improved, and the re-examination of cranial CT did not reveal any worsening of hydrocephalus and interstitial edema. The skull repair surgery restored the normal structure of the cranial cavity, which has positive significance to stabilize the intracranial pressure and improve the blood supply to the brain. The success of this case has accumulated valuable experience for our hospital to treat similar diseases in the future. At the same time, through collaborative efforts with sister departments such as the Department of Anesthesiology and the Department of Rehabilitation Medicine, high-quality medical resources within the hospital were integrated, which played a positive role in promoting the synergistic development of related specialties.