Fall with headstrike. GCS 5.
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Large right cerebral convexity extradural hematoma resulting in leftward midline shift, uncal herniation and brainstem compression. Heterogeneous appearance (swirl sign) suggestive of active bleeding. Early hydrocephalus and generalized cerebral edema.
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.