Immediate operative procedure is require. Any delay in evacuation of the haematoma can rapidly results in secondary brain damage. Outcome depends on the depth of penetration and clinical status of the patient, as well as the presence of other injuries. Removal of foreign bodies in the emergency room is a grave mistake. The foreign bodies must be removed by a neurosurgeon in the operating room.
Skull fractures occur through the cranial volta and the base of the skull.
Fractures may assist in identify patients who have a high risk of developing an intracranial haematoma. The value of the skull x-ray film is limited. Time should not be wasted performing radiographs of the skull to search for fracture. Attention to underlying brain injury should be the primary goal for a rapid diagnosis and management. The CT scan is more appropriate in detecting skull fractures.