Findings:
There is a large acute epidural hematoma overlying the left parietal and posterior temporal lobes measuring up to 22mm. This causes mass effect with approximately 5mm of rightward midline shift at the level of the third ventricle. There is medialization of the left uncus without evidence of transtentorial herniation. There are trace subdural blood products along the right tentorial leaflet. There is a left parietal scalp hematoma with edema. There is an acute nondisplaced fracture of the left parietal bone which crosses the squamosal suture and extends into the temporal bone. The fracture involves the ossicular chain and crosses the posterior and anterior walls of the external auditory canal. There is disruption of the incudomalleolar joint. The stapes is partially obscured by adjacent fluid. Partial opacification of the left mastoid air cells. There are 7 non-rib bearing cervical type vertebrae.

Impression:
Left parietal and posterior temporal acute epidural hematoma with mass effect resulting in 4mm of rightward midline shift.

Recommendations:
For your training purposes, recommendations are not included in this report.