In this study, 72 patients with head injury, hospitalized in the Intensive Care Unit (ICU) were analyzed. All of them required prolonged intubation. Every patient was initially intubated. Thirty (41.7%) of them underwent tracheotomy and 56 (77.8%) demanded mechanical ventilation. The patients were divided into three groups with respect to their treatment: 1. Patients intubated up to five days--27 (37.5%); 2. Patients intubated more than five days--45 (62.5%); 3. Tracheotomized patients--30 (41.7%). Tracheotomy was done between the fifth and the twenty-sixth day following the intubation. Laryngotracheal complications occurred in 47% of the patients from the second group and 23% from the third group. The patients in the first group developed no complications. Pulmonary infections prevailed in the second group. We conclude that early postinjury tracheotomy is associated with a lesser incidence of complications than prolonged intubation in neurosurgical patients.