In recent years, with the massive growth of transportation and diversification of recreational facilities, traffic accidents or emergencies are on the rise. Due to the lack of reasonable and effective self-protection for infants and young children, the incidence of cranio-cerebral injury in infants and young children is also increasing year by year, which is an important cause of death in infants and young children. The neurological system of infants and young children is different from that of adults, because their reticular superior system is not yet well developed, as well as other anatomical and physiological peculiarities, resulting in relatively complex diagnosis and treatment, and therefore their craniocerebral injury has its own characteristics. Mainly in: 1, the primary brain injury performance heavy: infants and young children after acute craniocerebral injury more prominent consciousness disorders, primary coma is more common, and the duration of consciousness disorders longer. The performance of the injury immediately after the emergence of obvious impairment of consciousness, and the degree of brain injury as shown in the imaging does not match. This is related to the poor stability of brain function in infants and children, the low cortical inhibition capacity, especially the reticular formation is not yet sound. 2, high incidence of epileptic canker: this is related to the instability of infants and young children’s cerebral cortical function, weak internal inhibition, excitation is easy to spread; the relative displacement of brain tissue and local fractures, bleeding after injury to the cerebral cortex motor area to form stimulation and provocation resulting in increased cortical excitability. The initial stage of the injury is often characterized by spasmodic twitching of the limbs, and after the injury is treated and its own function is restored, it gradually manifests as focal seizures. The incidence of cerebral contusions and acute subdural hematomas is low: intracranial hematomas in infants and young children after craniocerebral injury mostly occur at the site of external force, and the source of bleeding is mainly the rupture of platelet vessels at the fracture, pontine veins or arachnoid granule injury. Therefore, localized epidural hematomas often occur, but less often cerebral contusions and subdural hematomas, which is closely related to the physiological development of infants and young children. Infants and young children’s skull is still in the developmental stage, skull elasticity, skull base is relatively flat, and the volume of brain tissue is small, relatively more cerebrospinal fluid, so the head by external forces, the elasticity of the skull and cerebrospinal fluid can provide greater buffering capacity, flat skull base so that the brain tissue displacement and shear force between the skull base is less, rarely cause brain and blood vessel injury in the distant parts of the brain contusions. 4, infants and young children after craniocerebral injury: easy to appear in the basal ganglia area and the central part of the half oval cerebral infarction because the pediatric cerebral blood vessels are slender, the development of vegetative nerve function is not sound, self-regulation ability is poor, minor injuries can cause vascular displacement, distortion, elongation, spasm and even occlusion, so that the blood supply area of brain tissue ischemia, resulting in cerebral infarction; basal ganglia area and the central part of the half oval blood supply arteries from the doublestriatal artery, the anterior choroidal artery The blood supply arteries in the basal ganglia and the central part of the hemianopia come from the doublestem artery, anterior choroidal artery, white matter penetrating artery and branches of the basilar artery. These vessels are far from the main arteries, have long and curved rows, and branches from the main arteries are often at right angles, and have less collateral circulation. The direct mechanical injury to the wall of small blood vessels during traumatic brain injury causes organic stenosis or occlusion, resulting in interruption of blood supply; the blood vessels are stimulated by the injury and are prone to local vasospasm and the release of tissue thrombin, which activates the transformation of plasma prothrombin into thrombin and the transformation of plasma fibrinogen into fibrin, promoting platelet adhesion and aggregation to form thrombus, leading to cerebral infarction on the basis of cerebral vasospasm. 5, vital signs disorder is obvious: infants and young children’s nervous system is in the developmental stage, the cerebral cortex and plant nerve function is not yet sound, poor stability, life regulation center response to injury sensitive, so cranio-cerebral injury children often appear obvious vital signs disorder. They often show disturbance of body temperature regulation, change of respiratory rate, unstable blood pressure, and the condition can deteriorate rapidly within a short period of time. In addition, because of the small size of infants and children, less blood volume, and intense bleeding after scalp trauma, the injury is prone to a rapid decline in circulating blood volume, anemia, shock, and even death. Treatment principles: 1. Master the correct surgical indications. Infants and children with depressed fractures over 0.5 cm need surgical revision, otherwise, they are prone to brain development and epilepsy. All fragments of bone piercing the brain tissue should be removed. For depression depth more than 0.5~1cm, large depression area or sharp endoconvex fracture, early surgical repositioning should be performed. The larger bone fragments attached to the periosteum should be preserved as much as possible during surgery to facilitate later bony healing. Crushed fracture fragments should not be removed easily because there is a chance of self-healing when the defect area is small, which can avoid skull repair surgery at a later stage. 2.Epidural hematoma and simple subdural hematoma in infants and children are mostly venous hemorrhage, so decompression is generally not necessary after removing the hematoma, unless the preoperative cranial CT shows extensive cerebral contusion and brain swelling, or the brain tissue is obviously swollen during the operation and expands outside the bone window before considering debridement. Because the skull of infants and young children is still in the growth and development stage, debridement and decompression should be carefully selected to avoid the physiological and psychological damage caused by localized cranial defects in children who are unable to undergo cranial repair before puberty. Therefore, the diagnosis of pediatric craniocerebral injury should be clarified as early as possible, and the indications for surgery should be moderately relaxed. For those who have brain herniation or estimated intracranial pressure increase can not tolerate, as soon as possible to open the cranium to remove the hematoma is to release the brain tissue pressure, reduce intracranial pressure is a very effective means, timely surgery is often the decisive factor to save the injured child from death and disability. 3, neonatal subdural hematoma can often be cured by repeated punctures of the anterior chimney. 4.Infants and children with subarachnoid hemorrhage are prone to traffic hydrocephalus in the late stages. To avoid this, lumbar puncture and cerebrospinal fluid replacement should be repeatedly performed early to release the bloody cerebrospinal fluid. 5. Since canker sores can aggravate cerebral edema and cause increased intracranial pressure, further aggravating brain damage and even promoting the formation of cerebral temples, attention should be paid to the prevention of canker sores. For children with canker sores, systematic and standardized anti-canker treatment is necessary. 6. Pay attention to blood volume, electrolyte and internal environment balance. Infants and young children have relatively low blood volume and poor regulatory ability. In case of scalp, intracranial or intraoperative bleeding, the small amount can easily cause shock or even death. The treatment should pay great attention to blood loss in infants and children, and the amount of blood loss in infants and children should not be evaluated according to the perception of adults, and blood should be appropriately supplemented before and during surgery. At the same time, the application of dehydrating drugs such as mannitol should be strictly controlled to avoid aggravating the shortage of effective circulating blood volume due to excessive dehydration. Blood electrolytes and blood gas analysis should be reviewed regularly because of electrolyte disorders that may occur during the treatment process due to fasting and dehydration agents. According to the physiological and pathological characteristics of infants and children, weight and other factors, accurately calculate the amount of fluid intake to maintain the stability of the internal environment. 7. Keep the respiratory tract unobstructed. Because of the thin trachea of infants and young children, airway obstruction is easily caused by vomit and respiratory secretions. For children who cannot wake up in a short time or have serious misaspiration, tracheotomy should be done as early as possible to keep the airway open and reduce pulmonary complications. In summary, craniocerebral trauma in infants and children is a special type of traumatic brain injury with distinctive characteristics, which should be fully considered in the daily treatment process and often achieve very satisfactory results after active scientific treatment.