1) A 7-year-old male child presented with a severe head injury after falling 4 stories, with an initial normal CT scan but gradually rising intracranial pressure. 2) The patient underwent an emergency decompressive craniectomy due to refractory elevated ICP, which improved his condition and he was successfully extubated on the third postoperative day. 3) An audit of over 2000 head injury patients at this trauma center over 18 months found that 53% had severe injuries, with an overall mortality of 22%, rising to 36% for severe injuries.