Visible wounds of the scalp or obvious deformity or penetrations of the skull noted during the trauma assessment can indicate a conventional or penetrating TBI, which are more obvious and easier to diagnose.

Raccoon eyes or Battle’s sign, which are bruising around the eyes and behind the ears respectively, are signs of a basilar skull fracture.

The leakage of cerebrospinal fluid from the nose (rhinorrhea) or the ears (otorrhea) are other signs that might indicate a skull fracture.