Acute traumatic intracranial haematoma and skull fracture

The value of plain skull radiographs in acute head injury has been much debated. A prospective study is presented of the isolated predictive value of skull fracture, in addition to the level of consciousness on admission after trauma, for acute intracranial haematoma. In head injuries which were followed by such haematoma, skull fracture was significantly more common than in injuries without this sequel. The association was found at all levels of consciousness and was most pronounced in patients with minor or no diminution of consciousness on admission. Fractures crossing a vascular groove had additional predictive significance.