Diagnosis of craniocerebral injury According to the history of trauma and physical examination, as well as CT or MRI, which have been applied extremely commonly nowadays, there is generally no difficulty in diagnosis, but it should be noted that sometimes there is not always a very clear lesion in early imaging, and clinicians must judge the condition and make a diagnosis based on clinical manifestations and objective physical examination results. Early rehabilitation and care of traumatic brain injury The rehabilitation of traumatic brain injury should be carried out consistently, from the acute phase of injury to the recovery phase, and even lifelong rehabilitation. The earlier the rehabilitation, the better the prognosis for the future. The rehabilitation of traumatic brain injury includes the placement of good limbs, joint mobility training, turning, sitting, balance training, standing training, walking training, etc. during the bedside period, and also includes the patient’s language training, cognitive training, psychological counseling, etc. It also includes the training of daily living ability such as feeding, dressing, urinary and faecal care, breathing and skin management. Daily life care of traumatic brain injury 1. Maintain the regularity of life, diet and sleep. Gradually cultivate good living habits. 2.Patients with psychiatric symptoms should pay attention to avoiding various factors that stimulate psychiatric symptoms. 3.Give adequate nutrition and water according to the needs of the disease, if necessary, nasal feeding or intravenous high nutrition. 4.Pay attention to the quietness of the living room, the light should be dark, reduce all the interference to the patient. 5. When the patient’s memory and intelligence are impaired, it is difficult for him to express the symptoms, so the symptoms are hidden, atypical and coexisting with multiple diseases. It is necessary to observe the changes of the disease carefully and comprehensively. 6. Do not change the original lifestyle habits of patients in the chronic stage. For example, wake up early, wash, eat, place things, etc. can follow the nature. Try to encourage individuals to take care of themselves and do things they like. Enhance the patient’s sense of responsibility, such as being responsible for opening and closing the doors and windows of their own room, cleaning the bedside table, sweeping the floor, etc., so that they can maintain confidence in life. Rehabilitation care The rehabilitation of craniosynostosis is often long-term. Therefore, it is important to have a long-term plan along with a short-term plan. The former lies in saving lives and stabilizing the condition. The latter is to address the problems of the patient, planned rehabilitation, so that they can live independently and return to their families and society. Most of the post-injury physical disorders have been stabilized within 1 year, but the cognitive, behavioral and psychosocial problems often last for a long time. Therefore, after the acute phase and when the condition is stable, it is advisable to make a comprehensive neuropsychological examination in order to set the goal of long-term rehabilitation. If there are also behavioral, emotional, and cognitive disorders, they must be addressed first, otherwise the patient may resist, resist, or treat rehabilitation negatively, or many retraining methods may not be effective due to poor attention and memory. Cognitive rehabilitation is often long-term, so it is important to teach the patient’s family some practical methods that can be used for long-term training at home. (i) Early rehabilitation: Stabilize the condition, improve wakefulness, promote recovery from amnesia, prevent complications, and promote functional recovery. Prevention of pressure sores, prevention of joint contractures, prevention of infections, reasonable posture, 2. maintenance of nutrition, water and electrolyte balance, 3. arousal treatment, 4. bladder management, 5. treatment of comorbidities. 6. If the condition allows, hyperbaric oxygen therapy can be started early. (B) rehabilitation treatment during the recovery period Emphasis on integrated and comprehensive, craniocerebral injury patients are characterized by: 1, traumatic brain injury patients are more likely to occur after-effects of intellectual disability. Attention should be paid to the early start of various functional training and rehabilitation therapy care. To strengthen daily life, personal hygiene, diet, sleep and other basic care and training. Especially for those who cannot take care of themselves, they should be trained in living habits to prevent continued mental decline. Patients who are not severely demented should be guided to defecate regularly and develop the habit of regular defecation. 2. For patients with aphasia, insist on the principle of starting from easy to difficult, step by step, repeated practice and perseverance. Start with the patient’s least damaged speech function, such as the use of postural speech, eyes, gestures, etc. to communicate. Then use specific objects, single words, words and phrases for training. During speech training, pronunciation practice should be started as early as possible. During intelligent training, homework training should be carried out as early as possible. Music stimulation – Choose music that the patient is familiar with and likes, adjust the appropriate volume, let the patient listen to the music and observe the patient’s reaction to the music through the patient’s facial expression or changes in pulse, breathing, eye opening, etc. Verbal stimulation – the patient’s close people through call, speech and care at the same time with verbal command. 3.Once the vital signs are stable and conscious, the patient should be helped to perform deep breathing, active limb movement, bed activities and sitting and standing exercises as early as possible, gradually. Limb massage should be started from the distal joints, should start in the direction of normal limb function and passive movement first. At first, the patient is reluctant to move because of pain, then should be comforted and encouraged and slightly forced. Activities start with a short period of small movements, and gradually increase the amount. The patient should be encouraged to resume voluntary activities as soon as possible. 4.Extraction of tracheal tube: gradually block the tube and test the blood oxygen level until the tube is blocked for 48 hours and the blood oxygen level is still within the normal range, then the tube can be considered to be removed. 5.Gastric tube: If the swallowing function is improved, swallowing function training should be actively carried out and the gastric tube should be removed as early as possible; if the gastric tube is not removed within a short time, gastrostomy should be done as early as possible. 6, the problem of urinary catheter: the bladder should be well managed, must be regular and quantitative water intake, clamped urinary catheter open regularly to maintain bladder function. 7, management of post-traumatic epilepsy: prophylactic application of antiepileptic drugs is not advocated. For patients with confirmed post-traumatic epilepsy, antiepileptic drugs can be used reasonably according to the type of seizure. 8. Treatment of hydrocephalus: For patients at high risk of hydrocephalus, CT or MRI and changes in clinical symptoms should be monitored regularly, and ventriculo-abdominal shunt surgery should be performed when appropriate. 9.Cranial repair: For cranial defects caused by trauma or surgery, it should be considered whether to perform repair surgery depending on the general condition of the patient, as well as the defect site, size, intracranial pressure, infection and other conditions, and the duration of the disease. The skull defect should be repaired as soon as the condition allows. 10. Hyperbaric oxygen therapy is of great practical significance to improve the prognosis of patients with traumatic brain injury, increase the cure rate and reduce the disability rate. The principle of hyperbaric oxygen therapy for traumatic brain injury is to rapidly increase the blood oxygen content, raise the partial pressure of blood oxygen, strengthen the diffusion of blood oxygen, correct cerebral hypoxia, promote the establishment of collateral circulation, improve brain cell metabolism, and promote the recovery of damaged brain cells. Hyperbaric oxygen can promote the recovery of neurological function, and can promote the recovery of hemiplegia, aphasia, memory comprehension and other neurological functions after traumatic brain injury, and reduce the occurrence of sequelae.