Traumatic basal subarachnoid haemorrhage (TBSAH) refers to a severe basal centred bleed, almost invariably resulting from a micro-tear or in exceptional circumstances a more lengthy dissection of the intracranial vertebrobasilar arterial system. This is typically caused by an impact to the side of the upper neck, angle of jaw and/or ear/mastoid region. TBSAH is typically associated with an immediate comatose state, often accompanied by the intervention of cardiorespiratory arrest. Delayed presentations are rare but do occur and may be related to dissections or traumatic false aneurysms. The forensic approach to cases of suspected TBSAH can be a very rewarding exercise if carried out with due diligence and technique as this may yield evidence informative on (i) any predisposing vasculopathy enhancing susceptibility to tearing, (ii) whether undue force was implicated and (iii) incontrovertible, pathognomonic evidence of a mechanical basis of rupture confirming overstretching of the vessel, thus ruling out natural disease such as a berry aneurysm. The main focus of this presentation will be to discuss optimum techniques addressing these issues. Whilst the source of haemorrhage is intracranial, best practice includes examination of the extracranial vertebral arteries which does not need to be an onerous task.