307 cases of acute traumatic intracranial haematoma in patients admitted to the Institute of Neurological Sciences in Glasgow have been analysed for various presenting features. 57 (19%) had no fracture, and 14 had neither a fracture nor neurological symptoms and signs immediately after the injury. Apart from the children, immediate admission and observation of these 14 cases for a period of 24 hours rarely led to the early detection of a haematoma.