The neurosurgical approach to skull-brain trauma is described in detail and richly illustrated: from preclinical and clinical initial care to indication-specific imaging, as well as follow-up and the fundamentals of neurological rehabilitation. The focus is on the surgical treatment of acute trauma, which is presented step by step for typical injury patterns with numerous illustrations. Additionally, the authors discuss the various forms of cranioplasty to cover the calvarial defect. The presentation is based on the extensive expertise of the authors from a certified trauma center.