A series of consecutive 782 children with severe head trauma and spinal cord injury who were managed surgically or conservatively in the Department of Neurosurgery, Medical Academy in Poznań during 31 years was analysed. The clinical history, severity of injury (scales AIS, ISS), outcome of head and spinal cord injuries are reviewed. Factors important in predicting a poor outcome included the presence of brainstem contusion, intracranial haematomas and complete and severe partial spinal cord lesions.