Objiective:to summarize the early treatment of severe bifrontal intraparenchyma contusion associated with central herniation. Mehthod:clinical presentation of 41 cases of secere bifrontal contusion associated with central herniation were analyzed retrospectively. Resolts:12 cases had good overcome

13 mild morbidty

2 severe mordity

1 were in persistent vegetative state

3 mortality.Conclusions: Attaches great importance to patients with severe bifrontal brain contusion associated with central herniation

close observation of patients with their consciousness

pupil and changes in vital signs;attend that it is premature to stop dehydrating agent

too fast

to review the head dynamic CT

the right to master surgical indications.Early removal of necrotic brain tissue and cranial decompressive craniectomy to be effective in improving the cure rate of patients.