If early diagnosis of craniocerebral injury is not achieved, patient survival and prognosis are poor. Hypoxemia and hypotension can increase the mortality rate of patients with craniocerebral injury. The following conditions are potentially dangerous but difficult to diagnose and treat in primary care. It is important to treat them to the best of your experience and condition. Classify and diagnose the casualty according to the injury: Acute Epidural Injury – Basic Signs l Mentation changes from wakefulness to coma and deteriorates rapidly Middle meningeal artery hemorrhage with rapidly increasing intracranial pressure Contralateral hemiparesis with fixed ipsilateral pupil Acute Subdural Hematoma – Clot in the subdural space with severe contusion to localized brain tissue. The cause is a tear in the bridging vein between the cortex and the dura mater. The management plan is surgical, with drilling and decompression as soon as possible. The following should be treated conservatively, as surgery at this point is unlikely to improve the outcome: Fracture of the base of the skull – bruising of the eyelids (panda’s eyes) or mastoid bruising (Battle’s sign), leakage of cerebrospinal fluid from the ears and nose Cerebral contusion – transitory alteration of consciousness Sunken skull fracture – fragmented pieces of the skull that can puncture the dura mater and brain tissue. brain tissue. Intracerebral hematoma – most often seen in acute injuries or secondary to cerebral contusion The most common failures in the diagnosis and resuscitation of craniocerebral injuries are: Failure to perform initial resuscitation in a timely manner, failure to prioritize, failure to detect underlying craniocerebral injuries Failure to perform a basic neurological examination of the patient Failure to reexamine the patient as his condition deteriorates Altered state of consciousness is a hallmark feature of craniocerebral injuries