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Right sided scalp haematoma and skull / petrous temporal bone fracture with contrecoup left cerebral convexity acute subdural haematoma producing substantial mass effect with midline shift and left uncal herniation. The uncal herniation is severe and well identified by observing the temporal horn of the left lateral ventricle descending below the tentorium. Small volume traumatic subarachnoid blood is also present and there are small right temporal intraparenchymal haemorrhages. In addition to the right petrous temporal fracture, there is haemorrhage within the sphenoid sinus indicating other skull base injuries.