I believe that we are no stranger to traumatic injuries such as car accidents. In the eyes of the general public, victims who suffer from traumatic brain injury after a car accident are often bloodied and spattered, unconscious and unconscious on the spot. People usually think that these victims will die before the ambulance arrives, but is this true? Today, we will provide you with some clinical knowledge about traumatic brain injury related to car accident trauma. Statistically it is actually true that there are not many cases of on-the-spot craniofacial impact deaths in car accidents. Disturbingly close to 50% of injuries are due to intracerebral hemorrhage, brain swelling, and brain herniation patients die a few hours later. This is because of the hard cranial bone encasing the outside of the skull. After the brain swelling there is no space and eventually the brainstem respiratory and circulatory centers are compressed, leading to death. So the key treatment to save the life is to give the brain-open window, remove the hematoma, and reduce the intracranial pressure. Here we introduce the composition of intracranial pressure there are three contents in the cranial cavity, namely brain tissue, cerebrospinal fluid and blood. The intracranial pressure is the pressure generated by the contents of the cranial cavity on the cranial wall, and normal intracranial pressure is necessary to ensure that the central nervous system completes various physiological functions. The normal adult cranial cavity is a cavity composed of the skull base and skull cap bones, which has the role of accommodating and protecting its contents. In addition to the access to the cranial cavity and the skull base hole to the outside of the skull, the cranial cavity can be regarded as a completely closed container and cannot be expanded due to the hardness of the cranial bones that make up the cranial cavity. When the victim has brain hemorrhage, followed by brain tissue necrosis and edema, leading to further increase of intracranial pressure and even brain herniation, the patient suffers from respiratory and cardiac arrest, circulatory failure and finally death. Therefore, if the increased intracranial pressure is resolved in time, the patient can avoid losing his life due to brain herniation. Therefore it is especially important how to reduce intracranial pressure in the first place, improve brain tissue edema, and avoid adverse clinical events such as brain herniation. The most commonly used debridement decompression in clinical work is described below. This procedure can remove about 95% of unilateral supratentorial acute intracranial hematomas, and has the following advantages over conventional craniotomy decompression: wide exposure, low bone window position, direct visualization to remove contused tissues and hematomas in frontal, temporal and parietal lobes and anterior and middle cranial fossa and intraoperative hemostasis. The decompression is adequate, because the bone window reaches the frontal zygomatic process and the lower edge reaches the zygomatic arch, the temporal scales and the outer 1/3 of the pterygoid crest are occluded, which eliminates the pressure of the brain swelling on the lateral fissure vessels and the convex cerebral veins, promotes blood return, reduces brain expansion, and achieves the purpose of adequate external decompression. If necessary, the frontal pole and temporal pole were removed to achieve adequate internal decompression, so that the intracranial tissues have a larger compensatory space, which helps buffer the increased intracranial pressure and smoothly pass the peak period of cerebral edema. Avoid postoperative brain tissue entrapment and necrosis at the bone window due to the small bone window. The first has the surgical indications of supratentorial hematoma, plus the following two conditions: 1, severe hedgehog cranial injury with obvious impairment of consciousness, accompanied by the beginning of pupillary changes; 2, preoperative CT shows cerebral contusion, severe cerebral edema, midline shift ≥12.5px as well as compression and disappearance of the lateral fissure pool and basal pool of the brain, or disappearance of the lateral fissure pool and third ventricle compression. If the intracranial pressure is high, decompression of the large bone flap can be performed at the same time.