The cytoskeleton is important in the structure and function of the neu
ron. Disruption of the cytoskeletal proteins occurs in a variety of fo
rms of acute brain injury including cerebral ischaemia and diffuse ano
nal injury. The final common pathway mediating neuronal cell death inv
olves loss of the integrity of the cytoskeleton and these disturbances
may have a key role in the progression of events following acute brai
n injury. This review aims to provide an insight into the neuronal cyt
oskeleton in the normal state and in disorders encountered in neurosur
gical practice.