Objective To investigate the effects of standard large trauma craniotomy on neuron-specific enolase(NSE)inflammatory factors in patients withintracranial hematoma caused by severe trau-matic brain injury(sTBI).Methods A total of 64 cases of sTBI patients were randomly divided into con-ventional surgery group (conventional group)and standard large trauma craniotomy group (standard group),with 32 cases in each group.The postoperative Glasgow Outcome Scale(GOS)score,preoperative and postoperativeserum inflammatory factors(IL-8,IL-6,TNF-α,ICAM-1 ,and IL-1 0),NSE levels,and postoperative complications were compared.Results The GOS score of the standard group was signifi-cantly superior tothe conventional group(P <0.05);postoperativeIL-6,TNF-α,ICAM-1 ,and NSE levels in the conventional group were significantly reduced(P <0.05);postoperativeIL-8,IL-6,TNF-α,ICAM-1 ,and NSE levels were significantly reduced and IL-1 0 levelswassignificantly improvedin the standard group(P <0.05);there were3 cases of postoperative cerebrospinal fluid leakage and four cases of inci-sional hernia in the conventional group,and two cases of postoperative cerebrospinal fluid leakage and three cases of incisional hernia in the standard group;there were no significant differencesin the incidence of postoperative complications in both groups(P >0.05 ).Conclusion Inflammatory factors and NSE both playimportant roles in sTBI.Standard large trauma craniotomycan control these indicators effectively and reduce the severity of the patient's illness.