When computed tomography (CT) scanning is available, plain skull films contribute little or no additional information to the clinical management of the acute trauma patient. Traditionally, X-ray films of the skull have been used to detect skull fractures, intracranial mass effect (pineal shift), air-fluid levels, foreign objects (metal, glass, projectile fragments, etc.). However, the diagnostic yield of plain X-ray films is low because there is poor correlation between skull fractures and intracranial injury. The availability of the CT scout view or scanogram as a stand-in for any potential gain of plain film radiography is a reasonable choice in imaging these patients.