Abstract: Extremly severe cerebral inujries that cause usually brain hernia in 3 hours affer trauma showe-d a crisis and higher mortality,morbidity and vegetable survival rate.Many studies had benn recently reported for its treatment,but the decompression by the way of drilling in emergency room was rare. Twenty-five patients whose brain hernia developed in one a half hours after ttrauma were reported.. The decompressions were performed in the emergency room and satisfactory results ware acqaired.. The surgical indications, techniguesand effects were analysed and discussed.