Suspect an intracranial haematoma when a patient with a head injury has progressive headache, confusion, restlessness has neurological symptoms down one side of the body, primarily hemiparesishas epileptic seizuresis unconscious or the level of consciousness is decreasedhas pupil dilatation as a sign of threatening brain herniation (emergency situation). The diagnosis must be established rapidly – for an unconscious patient immediately. If you suspect a haematoma to be the cause of unconsciousness and referral would cause a delay, consult a neurosurgeon directly.