Early Rehabilitation of Patients with Heavy Craniocerebral Injury Lv Xueming, Department of Neurosurgery, General Hospital of Jinan Military Region, Jinan, China 13188873256 Heavy craniocerebral injury (HCI) is a complex and serious injury with high mortality rate. However, with the rapid development of neurosurgery, the survival rate of patients with severe craniocerebral injuries has been significantly improved by the effective work of the life support system, and most of the patients, although surviving, often have neurological dysfunctions of different degrees. The majority of patients survive, but often with varying degrees of neurological deficits, such as deficits in consciousness, movement, sensation, speech, cognitive function, and defecation and urination. These disorders can affect the patients’ life and work, bring pain and difficulties to the patients and their families, and also cause a great burden to the country. In the past, it was thought that it was impossible to recover from central nervous system injury, but through long-term clinical practice, neurologists Bathe A and Kennard put forward the theory of brain plasticity and functional reorganization as early as in the 1930’s. They believed that central nervous system injury is not due to regeneration, and that it is not caused by the regeneration of the brain. It is believed that central nervous system damage is not due to regeneration, but due to functional reorganization of the residual part to compensate for the lost function in a new way. In this process, rehabilitation is necessary. Furthermore, it is difficult to separate acute post-injury care from rehabilitation, and many avoidable disabilities can occur while the patient is still in the life-saving phase, if the problems that will be faced after survival are neglected. Therefore, early rehabilitation measures are crucial to the patient’s future functional recovery. Lv Xueming, Department of Neurosurgery, Jinan General Hospital, Jinan Military Region, Characteristics of Early Rehabilitation (1) Early rehabilitation can reduce the scope of neuronal necrosis and activate the early “immediate gene”, therefore, the earlier the rehabilitation intervention, the better. Some authors believe that rehabilitation should be intervened from the very beginning of craniocerebral injury to assess the severity of the injury and predict the prognosis in the acute stage, so as to provide a basis for further rehabilitation treatment. (2) Early postoperative rehabilitation should focus on restoring the physiological balance of the nervous system, centering on clinical drug therapy and applying other rehabilitation means at the same time, and all treatment measures should be based on the evaluation of the patient’s neurological function. (3) Early rehabilitation is not a specialized treatment but a comprehensive multidisciplinary joint treatment, which should be carried out under the guidance of neurosurgeons, and the treatment of patients should be combined with treatment, rehabilitation and nursing care. (4) The purpose of early rehabilitation is not only to reduce the morbidity and mortality rate, but more importantly, to improve the success rate of waking up, and lay a good foundation for functional rehabilitation in the recovery period. Patients with severe craniocerebral injury often fall into coma immediately after injury, and the time of awakening is an important factor affecting the prognosis, therefore, rehabilitation intervention should be carried out during the coma period. Therefore, rehabilitation interventions should be carried out during the coma period. ” Early passive rehabilitation in conjunction with awakening treatment avoids the further development of the disabling state, and lays a good foundation for the recovery of function after awakening. ” Replacing passive treatment with active rehabilitation treatment as early as possible after awakening promotes further recovery of limb function. Comatose patients should pay attention to limb placement and passive functional movement, which directly affects the patient’s motor function after awakening, to prevent the emergence of disuse syndrome and misuse syndrome; ” Swallowing function training is directly related to the patient’s eating, the use of iced saline stimulation of the pharynx, to promote the recovery of swallowing function; ” Hyperbaric oxygen can increase the oxygen supply to the brain, by increasing the blood oxygen concentration, increase the oxygen supply to the brain, to increase the blood oxygen concentration, to increase the blood oxygen concentration, to promote the recovery of the function, and to improve the oxygen supply to the brain. It can improve the metabolism of brain cells by increasing the blood oxygen concentration, increasing the blood oxygen tension, expanding the effective diffusion radius of oxygen in the tissues, and thus improving the metabolism of brain cells. In addition, under hyperbaric oxygen, the cerebral blood vessels can be constricted at the same time when the oxygen supply to brain cells is improved, so that cerebral edema can be controlled, which is helpful for reducing the secondary damage to brain tissues. In addition, by restoring and maintaining the cellular “pump” function, eliminating sodium and water retention in the damaged brain cells, it can also reduce cerebral edema, and at the same time, it can also promote the recovery of reversible cells, promote the formation of capillaries in the damaged area and the establishment of collateral circulation, improve the function of the brainstem, activate the reticulo-superior system, and thus promote the early awakening of the patient. Acoustic music, photoelectricity, and all kinds of sensory stimulation, motor function promotion techniques are conducive to increasing the tension of the central nervous system, lowering the wakefulness threshold of the patient, thus regulating the abnormal inhibition of the reticular system of the cerebral cortex, improving the consciousness disorders, protecting the normal brain cells and brainstem function, and promoting the awakening of the patient. “After surgery, some brain cells of patients with severe craniocerebral injury are damaged, due to the structural or functional reorganization of the central nervous system or plasticity, some neurons can be regenerated when the conditions are suitable, the application of neural facilitation technology to promote postoperative functional compensation and functional reorganization of the brain, and in the rehabilitation therapy, through the training of motor function, the receptors can be received by the afferent impulse to promote the function of the cerebral cortex. In the rehabilitation therapy, through the motor function training, the afferent impulses received by the receptors can promote the plasticity development of the cerebral cortex function, so that the lost function can be restored again, and the normal motor function pattern of the limb can be formed, so as to achieve the maximum restoration of the motor function, thus avoiding the occurrence of the disuse syndrome and the misuse syndrome, and guaranteeing the restoration of the function of the limb after the operation. “Physical therapy for paralyzed limbs can improve blood circulation of paralyzed limbs, reduce muscle tension, promote functional recovery, delay and prevent muscle atrophy. Acupuncture and moxibustion therapy has a good regulating effect on the overall function and local function of human beings, and acupuncture can promote the regeneration of injured peripheral nerves. Therefore, early rehabilitation for patients with severe craniocerebral injury can maximize the recovery of their functions, which can significantly improve the quality of life and self-care ability of the patients, and is conducive to the reintegration of the patients into the society. Lv Xueming, Department of Neurosurgery, Jinan General Hospital, Jinan Military Region, China