Objective To study early treatment strategy for brain hernia combined with hemorrhagic shock and the effect on prognosis of patients with severe head injury.Methods 252 cases of patients with severe head inju-ry and brain hernia combined with hemorrhagic shock in the mergency intensive care unit were divided into the obser-vation group and control group according to the stochastic indicator method,each group in 126 cases.The two group were treated with early treatment strategy and traditional treatment mode,respectively.The advantages and effect of two modes were analyzed.Results The majority of patients had united injury,such as soft tissue injuries,pelvis and spine fractures.There were 136 cases of patients with mild brain hernia and the rate of patients with hemorrhagic shock was 62.30%(157/252).The mortality was 34.13% in the observation group and 48.41% in the control group.There was significant difference(χ2 =5.306,P=0.021).The ratio of patinents with mild disability was 56.35%(71/126) in the observation group and the control group was 35.71%(45/126).The severe disability,vegetative state and death was 43.65%(55/126) in the observation group after the follow-up of 6 months.It was significantly lower than that of the control group(χ2 =5.306,P=0.001).Conclusion The early strategy treatment has a positive effect on reducing the mortality of brain hernia combined with hemorrhagic shock of patients with severe head injury the GOS for the prognosis disability increases significantly.