脑外伤病人是否需要手术主要从以下几个方面来考虑:(1)病人神经功能状况;(2)影像学检查;(3)颅外损伤程度;(4)病变的动态观察。现将一些神经外科常见损伤的手术适应证讨论如下。1 硬膜外血肿和硬膜下血肿一般而言,所有急性硬膜外血肿或硬膜下血肿,厚度≥1cm,中线结构移位明显者需要紧急手术;厚度≥5mm,中线结构移位≥5mm,GCS≥8分者也需要紧急手术;硬膜下血肿为一薄层,厚度≤3mm,伴明显脑肿胀,中线结构移位明显者,手术 Brain trauma patients need surgery mainly from the following aspects to consider: (1) the patient’s neurological status; (2) imaging studies; (3) the extent of extracranial injury; (4) the dynamic observation of lesions. Now some of the common surgical indications of neurosurgical damage are discussed below. 1 epidural hematoma and subdural hematoma In general, all acute epidural hematoma or subdural hematoma, thickness ≥ 1cm, significant shift in the median line of the need for emergency surgery; thickness ≥ 5mm, the median shift of 5mm , GCS ≥ 8 points also need emergency surgery; subdural hematoma is a thin layer, thickness ≤ 3mm, with significant brain swelling, significant shift in the midline structure, surgery