Pain Skull
 

What does this item actually do? I couldn't figure it out from the description.

It adds +2(?) to your attack at the cost of 50% of your mana. The skull is bound by a spell that slowly runs out as you go through battles. It starts at 100%, and when it gets to 0% you can release the soul of the necromancer trapped inside. After that then the skull becomes more powerful and no longer takes half your mana from you.

Really nice item - i found one my first game but haven't seen it since :(

At the start of each fight your mana is halved, but you gain +2 attack and gain 50% more rage in fights.

I haven't gotten the spell down to 0%, so I can't comment yet.

+5 to int and atk. one of the best items in the game.

As sherwood said:

It halves your mana at the start of every fight, but gives +2 attack and 50% more rage.

Rage gain from Inquisitors isn't affected.

After approx 50 fights (random chance involved) it upgrades, giving +5 attack and +5 intellect (but no rage bonus). Its new form doesn't half your mana either.
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Triumph Sprint ST

Basically what I said, but I didn't want to list the exact stats because I thought it was kind of a spoiler.

When the Skull reaches 0% it costs no mana anymore.
So it's quite a nice boost for rage generation. (i transformed it before the last fight)

Thanks, that's a bit rough to fight at half mana for 50 battles. If I were a warrior then maybe I'd think about it.

But it really is the perfect mage item :)

This current game has been a real downer for me. I've just completed the demon area and have not found any nice items (the first game was the best in terms of items). Btw the first game was a mage and I did suffer the use of this helmet (as previously mentioned) and it goes very well with the frog wife since she has a helmet slot :)