In the era of the automobile, bicycle, and motorcycle, trauma to the head constitutes one of the most frequent neurological problems presented to emergency room physicians. Not all head injuries involve the brain. Significant scalp lacerations and simple skull fractures may be present without the development of significant neurological deficits. On the other hand, closed head injuries may be present with significant neurological signs but without major external signs of head trauma (i.e., the scalp and skull appear intact).