Summary Background: Skull and brain injuries are responsible for around 20 percent of medical treatment cases in military conflicts and for the high mortality between the first hour after wounding. Perforating as well as closed head trauma including traumatic intracranial hematoma need urgent diagnosis and appropriate surgical therapy, whereas this is inaccessible in the center of combat actions. Cranial computed tomography is the diagnostic standard in neurotraumatology, but rarely available in the field. Whereas early detection of intracranial hematomas is a positive predictor for reduced mortality and better neurological long-term outcome in patients with cranial trauma. Therefore a mobile laser optic system for the early detection of intracranial hematomas in the pre-hospital phase was studied. Method: 100 patients were examined using this near infrared spectroscopy system and the results were compared with corresponding CT or MRI films. Results: Out of 55 patients with intracranial hematoma this was detected in 37 cases (67,3 %). The absence of hematomas was correctly shown in 39 of 45 patients (86,7 %). Discussion: Near infrared spectroscopy can not replace the cranial computed tomography in patients with head injury, but it is an additive diagnostic tool if computed tomography is not available. Unilateral hematomas nearly underlying the cranial vault are detectable in a save manner if artificial factors are eliminated â?? this is not given in all patients with severe skull injury. The system is helpful for continuous monitoring of patients with mild to moderate skull trauma to detect delayed traumatic intracranial hematomas. Beside this in patients with apoplexy the ischemic brain lesions were good limitable from spontaneous intracerebral hemorrhages in our study. further informations about crainscan (GER)