 The study found that implementing optimized treatment tactics in combination with identifying and treating fat embolism syndrome, FES, resulted in a significant decrease in overall mortality compared to traditional approaches. Overall mortality was 31%, which decreased to 12.2%, 23.2%, and 40.3% for groups I, IIA, and IIB respectively. Additionally, mortality after conservative treatment was 55.7%, which decreased to 21.4%, 100%, and 100% for groups I, IIA, and IIB respectively. This suggests that optimized treatment tactics can be used to effectively reduce the lethality in the acute period of severe combined craniocerebral injury, SCCI. This article was authored by A. A. Razakov and M. K. Nazarov.