Traumatic intracranial foreign body refers to the open cranial injury caused by trauma, so that broken bone fragments, metal foreign bodies remain in the cranium, the wound can also bring in hair, sand, cloth, etc. and complicate the infection, in addition to the direct introduction of foreign bodies into the injury, the formation of a temporary cavity when the injury is caused, in the process of its pulsation formed during the negative pressure of the wound canal attraction, but also the foreign body near the wound can be inhaled. It is a relatively rare and difficult disease to manage clinically. The treatment of traumatic intracranial foreign body is divided into surgical treatment and conservative treatment. The indications for surgery are: (1) foreign body of 1.0 cm or more. (2) Located in non-functional areas that can be easily removed, with less surgical trauma and risk. (3) Causing clinical symptoms, such as those leading to intracranial infection or causing intractable epilepsy. However, for some special functional areas and foreign bodies that have been around for a long time after the injury, wrapping adhesions have been formed, and the clinical symptoms are not obvious or the foreign body is too small, conservative treatment is the main treatment, and surgical treatment is not possible. If the foreign body has been retained for a long time, the location is deeper, there are no obvious neurological symptoms, seizure medication can be controlled, there are no signs of infection, and there is a high risk of surgery or the possibility of neurological dysfunction after surgery, surgery to remove the foreign body is also not recommended. However, it is generally believed that organic foreign bodies such as wood are likely to harbor bacteria, and if the injury is not long afterwards and the location is superficial, the foreign body can be considered to be removed without aggravating the neurological impairment. Preoperatively Preoperative prediction of the nature of the foreign body, especially the distinction between magnetic and nonmagnetic objects, is crucial in deciding which surgical approach to choose. Common foreign bodies include metal, glass, and wood. Metal is denser and accompanied by artifacts, which can be easily detected. The use of bone window position can reduce the interference of artifacts on the location of the foreign body; glass is also dense and slightly lighter in artifacts because of its dense composition and absorption of rays; vegetative foreign bodies have various manifestations, and their density can be similar to fat, water or soft tissue or even higher because they are themselves dry, moist, or soaked in blood, cerebrospinal fluid or pus in the brain. However, it should be noted that some patients are misdiagnosed as glass because of the higher density of the wood strips; some patients have obvious glass artifacts and are mistaken for metal. Therefore, a detailed history should be taken and attention should be paid to the external wound, especially when a non-metallic foreign body is suspected, and MRI examination or ultrasonography should be added if necessary. However, the absence of paramagnetic metallic foreign bodies should be clarified before MRI examination is performed. Postoperative general care Closely observe the changes of consciousness and pupil, monitor the vital signs and oxygen saturation, observe the movement of limbs and seizures, and keep the cerebral drainage tube and urinary catheter unobstructed. Due to the location of the intracranial foreign body and the degree of brain injury, the time of patient wakefulness after surgery varies. According to the state of consciousness at the time of admission, the physician should be notified promptly when the consciousness does not gradually improve after 6 h after surgery to help determine whether there is secondary intracranial hemorrhage or severe cerebral edema. After anesthesia, patients may experience coma extension and irritability during the process of recovery of consciousness, and should make timely judgment of their condition and be handled in a timely manner. Respiratory management During the awakening period after surgery, artificial airway is used to assist ventilation, and oxygen is administered after resumption of spontaneous breathing, and suction devices are prepared at the bedside. After removal of tracheal intubation, nebulized inhalation should be given 3-6 times a day. Open cranial injury is more likely to lead to epilepsy due to dural rupture, brain parenchyma contusion and foreign body retention, so it is more important to keep the airway open during seizures, tilt the head to the side during seizures, and try to stretch the airway to increase oxygen flow. Intracranial infection Clinically, patients often have headache, vomiting, neck tonicity, high fever and rapid heart rate, shortness of breath, and prompt treatment of symptoms. In the case of hyperthermia, physical cooling is usually applied. In case of poor results, temperature control blankets can be used. During special physical cooling, observe the patient for chills, restlessness, muscle tension, and goose bumps on the skin, monitor the temperature, and record it every hour. Perform lumbar puncture, inject drugs under strict asepsis, and lay flat with the pillow removed for 6h after the operation, and observe whether there is bleeding or exudate at the puncture site. Traumatic intracranial foreign body injury can be simple or complex, and the trauma may be small and the observation of the condition will be neglected. The nature and size of the foreign body, the location of the intracranial foreign body in relation to the skull, the location in relation to the venous sinus, the location in relation to the functional and non-functional areas of brain tissue, and the location in relation to the eye and posterior ball tissue should be clarified before surgery. Preoperative localization using CT or X-ray is more effective for the treatment method of traumatic intracranial foreign bodies. Intraoperative cranial foreign body removal surgery using C-arm X-ray machine and ultrasound localization is an effective method for treating intracranial foreign bodies and can achieve satisfactory treatment results. Minimize damage when removing or extracting foreign bodies during surgery. The foreign body is repeatedly cleaned and flushed after removal and antibiotics are used to reduce the chance of infection. The patient’s prognosis depends mainly on the degree of damage to brain tissue and important blood vessels caused by craniocerebral trauma and the infection.