This assessment involves 81 patients treated between two regional major trauma centres in the UK. Fifty sustained a predominantly anterior directed force and 31 a lateral impact. They found that anterior impacts reduce the incidence of fracture propagated beyond the anterior cranial fossa allowing it to act like a ‘crumple zone’. The lack of such a zone of lateral forces resulted in fracture propagation and transmission throughout the skull base, particularly into the middle of the posterior cranial fossa.