83 Summary W e analyzed a series of 142 patients suffering a frontobasal injury severe enough to produce a frontobasal fracture. High velocity trauma was the cause of injury in 95 patients (67%). A frontobasal fracture was the only noticeable lesion in 27 cases (19%). It was associated with maxillo-facial fractures in 79 patients (56%), with intracranial lesions in 47 (33%), with in- traorbital lesions in 14 (10%), and with politrauma in 10 (7%). In 107 patients (75%) surgical treatment was required either to repair the craniofacial frac- tures and/or the intracranial and intraorbital lesions. In this group 62 patients (58%) were operated on by the maxillofacial surgeon only, 45 (42%) by a combined maxillofacial and neu- rosurgical team. 20 patients (19%) required an emergency operation because of an expanding intracranial mass or a craniocerebral wound. In 50 cases (47%) the operation was performed within 6 days from the trauma. Good cosmetic and functional results were obtained in 97 pa- tients (91%). Early or late severe intracranial infections were noted in 3 cases (3%). No case of neurological deterioration because of an early operation and no case of delayed CSF leak was found. Looking at our experience and the data reported by other Authors the decision making in the management of patients with frontobasal in- jury is based on the following steps: Decision Making in Frontobasal Injuries S.Zeme*, G.Gerbino°, F.Benech*, C.A.Pagni*, F.Roccia°, C.Caldarelli°, S.Berrone° * Department of Neurosciences, Neurosurgical Division, University of Turin (Italy) °Maxillofacial Surgery Division, University of Turin (Italy) 1) general assessment of the patient’s condi- tions; 2) assessment of the craniofacial fractures and their effects; 3) selection of candidates for surgical treat- ment; 4) choice of timing and the type of surgical procedure. A successful outcome is better achieved when: - a multidisciplinary team approach during all the steps of the decision-making is pur- sued; - an immediate diagnosis and treatment of the acute life-threatening lesions is ob- tained; - an early, one-stage, and complete repair of the craniofacial bones is performed. Key words: Frontobasal injuries, craniofacial fractures, management. Introduction Frontobasal injury is due to a trauma of the central or lateral mid- or upperface.