=Symptoms.= During the first few days subsequent to the injury the child merely suffers from the symptoms common to all severe head-injuries--concussion and brain irritation. The osseous lesion is obscured by the presence of a well-marked cephalhæmatoma. After the lapse of a short time--usually one to two weeks--the partial resolution of the hæmatoma allows one to observe, for the first time, that a definite tumour remains. This tumour is irreducible, pulsates freely, and may be translucent. If the protruding brain substance includes the precentral region--the motor area--definite weakness or paralysis of the opposite face and extremities may be observed. Usually, however, no such symptoms are forthcoming, and the child appears but little the worse for the accident. Shortly afterwards the tumour becomes more defined in outline, and careful palpation will reveal the defined margins of an osseous deficiency. Compression of the protruded mass will often throw the child into general convulsions, or induce a state of compression with dilated pupils, slow pulse, and stertorous respiration. Compression, however, seldom results in any marked diminution in the size of the tumour. The conditions may remain stationary, but, as a general rule, the hernial protrusion slowly increases in size and the child dies in general convulsions, preceded by symptoms of brain irritation or compression. =Treatment.= Three courses are available in the treatment of this condition:-- 1. Expectant treatment, combined with the application of pressure. 2. Aspiration and puncture. 3. Free exposure and further treatment according to the conditions found. In the majority of cases the local conditions preclude any attempt at radical cure--the gap in the skull is large, the margins of the deficiency are thinned and everted, and the brain enters largely into the formation of the projecting mass. Furthermore, the dura mater is torn and in a tag-like condition. Only in the most favourable cases--when the tumour is small and the gap narrow--can radical treatment be advocated. The application of pressure--without previous aspiration--exercises but little effect on the size of the tumour and, under such treatment, the danger of brain-compression is always present. Aspiration with the object of removing the fluid constituents of the tumour, and thus of reducing its size, has occasionally been followed by disastrous results. Still, many cases were so treated in the pre-aseptic days, and the modern methods of cleanliness should allow of better results. One or more aspirations may be carried out, this treatment to be followed by the application of steady and uniform pressure, preferably with the aid of elastic bandages, the degree of compression depending on the size and constituents of the tumour. The patient must be watched most carefully, in order to guard against the development of symptoms pointing to cerebral compression. Irritating injections should never be used.