Post emergency left craniectomy and subdural evacuation. Mild herniation of brain out the craniectomy defect. While the midline shift and the uncal herniation have resolved, a greater size and and number of intraparenchymal haemorrhages are now seen in addition to subdural blood on the tentorium and along the right cerebral convexity. It is common for this extension of intraparenchymal bleeding to occur once the tamponade effect of raised intracranial pressure is released. Importantly, there is now hypoattenuation and possible petechial hameorrhages evident within the right side of the midbrain. This has occurred to compression of this side of the midbrain against the tentorium when the contralateral uncal herniation was present (Kernohan notch) and accounts for the patient's left hemiparesis prior to losing consciousness (Kernohan phenomenon).