The manifold can be constructed by first plumbing together disc bundles of Euler number 2 over the sphere, according to the Dynkin diagram for E8. This results in PE8, a 4-manifold with boundary equal to the Poincaré homology sphere. Freedman's theorem on fake 4-balls then says we can cap off this homology sphere with a fake 4-ball to obtain the E8 manifold.