This paper outlines the pathological mechanisms and clinical presentation of traumatic brain injuries. The surgical management of patients with intra cranial pathology following head injuries is described. Prompt treatment of intra cranial haematomas following head injury is associated with a good outcome. Delayed surgical treatment has a worse prognosis. Patients presenting with a diffuse brain injury also called diffuse axonal injury not amenable to surgical treatment have a high mortality or are left with a devastating neurological injury. There is clearly room for fruitful collaboration between neurosurgeons and those professionals in the mechanical engineering and computer sciences with a special interest in the causation of traumatic brain injury.