Post-traumatic brain injury intracranial infection is a serious nosocomial infection, once the post-traumatic brain injury infection occurs, the light patient treatment time is prolonged, the cost is increased, increasing the patient’s pain, and the serious patient’s life is endangered, so we should pay great attention to it in the process of clinical work, from November 2007 to March 2009, our department Treatment of intracranial infection after traumatic brain injury 13 cases, now the experience of treatment is analyzed as follows. 1. Clinical data 1.1 General data 8 cases in men and 5 cases in women: age 8-70 years old, average 41 years old. All were traumatic brain injury, including 5 cases of subdural hematoma, 5 cases of subdural hematoma combined with cerebral contusion, 5 cases of intracranial multiple cerebral contusions, and 1 case of cerebral contusion broken into the ventricle. 2.1 The operation time ranged from 2 to 6 hours, with an average of 3 hours. External drainage was placed after craniotomy. 1.3 Clinical manifestations of high fever, headache and meningeal irritation were common clinical symptoms from 3 to 14 days after surgery, and fever was the most significant symptom, so all patients had fever, and the maximum temperature could reach 40 degrees, and meningeal irritation was another significant manifestation, and 9 patients had meningeal irritation. 1.4 Laboratory examination cases leukocyte count (11-40)*109/L. Cerebrospinal fluid leukocyte count 10-106/L or more, the highest 20*106/L; biochemical examination: protein in 0.4/L or more, sugar and化物 decreased, bacterial culture positive 9 cases, including G-6 cases, G+ 3 cases. 2, prevention and treatment process and methods 2.1 To reduce the occurrence of intracranial infection after neurosurgery, the following precautions can be taken: 1 perioperative period for each patient to make a specific analysis, the heart, liver, kidney and other major organ function to do a good and adequate evaluation, and give appropriate treatment, so that patients can tolerate surgery. 2 preoperative prophylactic use of antibiotics, generally used once after the start of anesthesia induction, such as surgery time If the duration of surgery exceeds 5H, depending on the half-life of the antibiotics used, another dose may be administered during surgery and postoperatively until the drainage tube is removed.3 Perform surgical maneuvers skillfully and smoothly to minimize the operative time.4 Strict intraoperative aseptic operation to minimize the exposure time and scope of brain tissue. Correctly place the drainage tube and close the cranium with tight sutures in layers.5 Postoperative drainage tube should not be left in place too long, usually 1 to 2 days.2 Early diagnosis of postoperative intracranial infection is of great importance. Observation of body temperature is an important tool for early detection of intracranial infection. If there is no decreasing trend of temperature or sudden increase of temperature after 3 days after surgery, the possibility of intracranial infection should be considered, and if it is accompanied by meningeal irritation, it is more suggestive of intracranial infection. The diagnosis of suspected intracranial infection should be confirmed as soon as possible by lumbar. If the leukocyte and protein content of the cerebrospinal fluid increases and the sugar and chemical content decreases, the diagnosis is clear. 2.3 In this group of cases, on the basis of active treatment of the primary disease, sensitive antibiotics were selected according to the results of bacterial culture and drug sensitivity, and antibiotics were given in different ways according to the cause and degree of infection. Once the intracranial infection is diagnosed, we should give sufficient amount of effective antibiotics. Before the results of bacterial culture and drug sensitivity are available, we can use antibiotics that can easily cross the blood-brain barrier according to our experience, and we should adjust the medication after the results of drug sensitivity are available. 2.4 For light infections, intravenous administration alone is used; 2.5 For heavy infections, a combination of intravenous and intrathecal injection is used.G- causes a high proportion of intracranial infections, and aminoglycoside antibiotics are effective against most G-bacteria causing intracranial infections, because it is difficult to cross the blood-brain barrier, intrathecal injection or intraventricular drainage tube injection of antibiotics has become an effective way of administration, because of its simple operation and efficacy. It is widely used because of its simple operation and certain efficacy. Some patients need repeated lumbar subarachnoid puncture to release cerebrospinal fluid and intrathecal injection several times to achieve certain efficacy. 2.6 Hormone application is now very controversial, because of its role in preventing cerebral edema, reducing inflammatory adhesions, increasing protein synthesis, thus enhancing the body’s resistance, and having a certain anti-endotoxic effect, a certain amount of hormone can be added for a short time on the basis of adequate application of antibiotics to control infection and improve symptoms, but long-term application of hormone can make the body’s immunity suppressed. Increase the chance of intracranial infection. 2.7 For patients with cranial osteomyelitis, epidural abscess, subdural abscess and brain abscess, active surgical treatment should be taken along with active application of antibiotics. Surgery for cranial osteomyelitis includes the complete removal of all infected bone and should be done in all directions, removing all free cavities containing purulent material until normal bleeding bone is reached. For epidural abscesses, surgical management also includes craniotomy or partial craniectomy to aspirate all purulent material and lethal necrotic tissue, debris, and to give adequate irrigation, and for subdural abscesses, surgical management includes craniotomy or borehole drainage to remove purulent material, followed by intravenous application of antibiotics. For brain abscess, surgical management takes into account the patient’s age, neurological condition, location of the abscess, stage and type of abscess, and the presence of multiple foci, and selects abscess puncture and aspiration, continuous drainage by abscess puncture catheter, and abscess excision, respectively. 3. Treatment results: 11 cases were cured and 2 cases died. Discussion Intracranial infection after craniocerebral injury is a broad category, affecting multiple pathological processes affecting the brain, spinal cord, overlying tissues and their adjacent anatomical structures, and severe infection can cause death of the patient, which should be treated promptly with proper surgical and pharmacological treatment. Postoperative intracranial infection is a common complication of neurosurgical craniotomy. Due to the complexity of neurosurgery, long operation time and exposure time of the operation field, long time of postoperative drainage tube connecting with the outside world, leakage of cerebrospinal fluid after cranial loss, as well as the decrease of the body’s defense function after trauma and the destruction of the blood-brain barrier function, which makes the bacteria once invaded, the infection is not effectively controlled, but has a greater impact on the body, leading to the patient’s heart The infection will have a greater impact on the body once the bacteria invade and the infection is not effectively controlled, resulting in the patient’s heart, lungs, kidneys and other organ damage, and even the death of the patient with multi-organ failure. Therefore, every surgeon should be highly alert to postoperative infection in traumatic brain injury, pay attention to it before surgery, improve surgical proficiency during surgery, and observe carefully after surgery. We should try our best to prevent it before it happens, and to detect, diagnose and treat it as early as possible for patients who have already had it. This will reduce the mortality and disability rate of patients and improve their quality of life.