A 34-year-old man was admitted to the emergency department following physical assault, presenting with a head injury associated with transient impairment of consciousness. Initial computed tomography (CT) imaging revealed a deep intracerebral hyperdense lesion interpreted as a traumatic capsular hematoma. Based on these findings and the uncertain functional prognosis, a medico-legal certificate assigning a total temporary disability (TTD) of 90 days was issued during the early phase of criminal proceedings. Subsequent clinical evolution was rapidly favorable. Follow-up imaging demonstrated complete morphological stability of the lesion over time, raising questions regarding its traumatic origin. However, a subsequent civil expert assessment challenged this initial interpretation. Re-evaluation of the imaging demonstrated that the observed cerebral lesion might instead correspond to a pre-existing vascular malformation, although no definitive diagnosis could be established in the absence of complementary magnetic resonance imaging (MRI) investigations. In this context, the initially assigned TTD appeared overestimated, as a direct causal link between the assault and the intracranial lesion could not be established. This case highlights the difficulties associated with early medico-legal evaluation performed under diagnostic uncertainty, particularly in expedited judicial contexts where provisional medical conclusions may rapidly become incorporated into criminal proceedings. Beyond the radiological challenge itself, the report underlines the importance of cautious imputability assessment, explicit acknowledgment of diagnostic uncertainty, and the need for multidisciplinary reassessment in complex cases involving potential intracranial injury.