There is a longitudinal fracture through the left temporal bone extending into the middle ear and associated with incudomalleolar disruption and partial obliteration of the middle ear and mastoid air cells. This fracture extends also through the squamous and lambdoid sutures posteriorly and into the glenoid fossa of the left TMJ, without displacement. No signs of involvement of the carotid canal. No other skull fractures were seen. Left parieto-occipital subgaleal haematoma. A small amount of pneumocephalus noted along the middle and posterior fossa on the left. There are small foci of subarachnoid haemorrhage along the left silvan fissure. Ventricular system and cisternal spaces appear normal. Orbits have normal appearances. The paranasal sinuses are mostly clear and aerated.