The main difficulty in diagnosis and treatment of fronto-basal skull fractures can be said in two propositions: --On the one hand owing to the fact that diagnosis of cerebro-spinal fistula is sometimes difficult; --on the other hand because therapeutic require intervention of several surgical teams. An anatomo-pathological classification should take into considerations the point of frontal impact which is: medio-facial, medio-cranio-facial, latero-cranio-facial and it sagittal outcome which is: frontal, ethmoïdal, sphénoïdal. Surgical indication whether meet urgent character or respond to clinical and radiological facts (rhinorrhea, pneumocephalus, meningitis, radiological suspicion of osteo-meningeal break). Surgical treatment will envisage primary and complete repair of neuro-surgical and maxillo-facial injuries.