This report describes the findings in four cows with a skull injury and accompanying brain trauma. The cows ranged in age from 1.5 to 5 years and were referred to our clinic because of fever and indigestion. The owners of two cows had noticed a skull injury prior to admission. In all patients, the general behaviour and condition were moderately to severely abnormal. Three cows were blind in one eye and one cow was blind in both eyes. Two cows pushed to the left when led, and two others had a head tilt. Bilateral ptosis was observed in one cow and unilateral ptosis in another. In all patients, a perforating injury to the frontal bone with accompanying brain trauma was seen on the right side. Samples of cerebrospinal fluid showed inflammatory changes in two of three cases. All cows were slaughtered; two had received treatment but did not respond favourably. Postmortem examination revealed extensive lesions, sometimes with abscessation, involving the right cerebral hemisphere at the site of skull perforation. Two cows also had purulent sinusitis affecting the right frontal sinus. Three of the skull injuries were thought to be due to a forceful horn injury from another cow and one to self-injury on a sharp object. To identify skull injuries in cattle with clinical signs of central nervous system disease, careful palpation of the external skull may be necessary.