An undisplaced fracture of the left parietal bone extending medially to the lambda propagating through the right lambdoid suture with associated diastasis. Associated large subgaleal haematoma overlying the left parietal/occipital bone. The displaced fracture through the mastoid process of the temporal bone with both a longitudinal and transverse orientation. The fracture extends through the tympanic part of the temporal bone, middle ear and into the temporomandibular joint. Associated right mastoid, right middle and external ear haematoma. Further extension anteriorly through the anterior and posterior walls of the right carotid canal into the body of the sphenoid. No obvious fracture extension into the left carotid canal. No other skull fracture was identified. Subcutaneous emphysema within the right masticator space is noted.
Large epidural haematoma associated with the aforementioned left parieto-occipital skull fracture measuring up to 15 mm in axial dimension. Extensive contrecoup injury characterised by a large right subdural haematoma overlying the right cerebral convexity measuring up to 15 mm. Small subdural haematoma overlying the anterior left frontal lobe and left parietal lobe.
There is significant cerebral oedema characterised by uncal hernication with diffuse effacement of the basal cisterns. No tonsillar herniation. Extensive loss of grey-white differentiation throughout the cerebral parenchyma.
