Objective To analyze the clinical characteristics of central brain hernia caused by bilateral frontal lobe contusion and laceration and timing of surgery, and to explore approaches for improving clinical outcomes.Methods A retrospective study was performed on clinical symptoms, imaging features, and timing of surgery in 62 patients with central brain hernia caused by bilateral frontal lobe contusion and laceration. According to the timing of surgery, the patients were divided into diencephalon group (n=34) and non-diencephalon group (n=28). The prognosis was compared between the two groups.Results The diencephalon group had a significantly better prognosis than the non-diencephalon group (Z=-3.154, P=0.002).Conclusions Early recognition of diencephalon and proactive craniotomy could promote the success rate of clinical rescue and improve the prognosis in patients with central brain hernia.