CERVICAL SPINE: There is no prevertebral soft tissue abnormality.
Nasogastric and endotracheal tubes are partially imaged. No fracture or malalignment is seen.
IMPRESSION:
1. Large left hyperacute on acute frontal-temporal-parietal epidural hematoma with significant mass effect, including rightward subfalcine herniation, uncal herniation, and downward transtentorial herniation with effacement of the suprasellar cistern. Mass effect on the midbrain is also present.
2. Associated nondisplaced fracture involving the squamosal left temporal bone which extends vertically along the left parietal bone.
3. Additional nondisplaced fracture involving the left temporal mastoids, extending into the left middle ear cavity, with associated hemotympanum.
4. No fracture or malalignment of the cervical spine.