Trauma or injury to the skull or spinal cord occurs most commonly due to vehicular accidents. Other reasons for injuries remain fall from height, fall of heavy object over the body or any cause we attribute as accidental. The injuries to brain and spine can be minor , major or critical which will necessitate urgent intervention. Surgery for such Brain injuries is required only under special circumstances like open fractures, blood clots or large swelling of the brain lobe. Surgery is spinal injuries is required if there is fracture , dislocation or imminent threat to limb function. The neurosurgeon is best trained to determine the need for such surgeries and also timing them so as to minimise damage and ensure recovery.