Technique

• Inspect the scalp by parting the hair in sections under good light; look for lesions, wounds, scaling, and nits along the hair shafts.
• Palpate the skull gently for tenderness, masses, and — after trauma — step-offs or depressions.
• Observe gross facial symmetry at rest and with movement; refer detailed cranial-nerve testing to Neurological.
• For a head strike, establish the mechanism and timing and perform serial neuro checks per order, comparing each to the last.
• Characterize any headache fully — a sudden “worst-ever” or thunderclap onset, or a new headache with neurologic signs, is a red flag.
• In older adults with headache, palpate the temporal arteries for tenderness and ask about jaw claudication and visual change.
• Confirm the current anticoagulant or antiplatelet regimen before judging the risk of any head injury.
• Inspect a shunt tract or cranial-surgery site, where present, for swelling, drainage, or signs of malfunction.