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Scalp haematoma with underlying right lambdoid suture diastasis extending as a fracture into the right petrous temporal bone (mastoid air cells) leading to the accumulation of subdural gas underlying the diastasis. Fracture through the mastoid air cells is so-called longitudinal in orientation (ie in the long axis of the petrous ridge) and enters the middle ear cleft leading to fluid (blood) accumulation. The tympanic membrane is perforated allowing this blood to leak into the external auditory canal.