Complex head injury is becoming a more frequent problem in clinical practice. In the case reported herein, radiographic studies were of particular value in disclosing the nature of the injury. The clinical picture suggested the possibility of a surgically correctable lesion. The radiographic findings, however, not only contraindicated operation, but permitted an exact anatomic diagnosis of a highly unusual condition. Clinical Summary S. L., a 59-year-old man, was struck on the head by a large beam. He was brought to the University Hospital within thirty minutes of the accident, unconscious, and with severe head and face injuries. A large ecchymotic, swollen area was present above the left eye. His nose was bleeding profusely, and the pharynx and both ears were filled with blood. The blood pressure was labile, the systolic varying between 140 and 110 mm. Hg and the diastolic between 80 and 70 mm. Hg. Respiration was rapid, deep, and regular, but labored. No response was elicited by painful stimulation or v...