There is a lentiform shaped large right anterior frontoparietal convexity extra-axial hematoma. Clearly, the shape of the hematoma suggests that it is epidural in location but it does cross the coronal suture, something that epidural hematomas should not do due to the tight dural adhesion at the sutures. Here, there is a parietal bone fracture that clearly extends to the coronal suture and so the dural attachments are likely disrupted allowing for the hematoma to cross the suture. Epidural location of this hematoma was surgically confirmed.

There are areas of parenchymal contusion both in the right inferior frontal lobe and the high right fronto-parietal lobe near the vertex.

Note in addition that the right parietal bone fracture extends inferiorly to the greater wing of the right sphenoid bone as well as the superolateral orbital wall. There is an associated intra-orbital, extra-conal hematoma exerting mass effect upon the right lateral rectus muscle.

Finally, notice that the sphenoid sinuses both have layering hematocrit levels. There is a fracture of the left sphenoid sinus lateral wall as well as a fracture of the sphenoid septum.

Incidentally, the patient had already undergone a right frontal burr hole for placement of an intracranial pressure monitoring device prior to this head CT. The outside hospital imaging prior to this head CT did not demonstrate the epidural hematoma.