Fall with headstrike. GCS 5.
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Large right cerebral convexity extradural haematoma resulting in leftward midline shift, uncal herniation and brainstem compression. Heterogeneous appearance (swirl sign) suggestive of active bleeding. Early hydrocephalus and generalised cerebral oedema.
There was also an undisplaced fracture through the squamous temporal bone (not well seen on thick slices). The patient went for urgent craniotomy and evacuation.