A 96 y/o female found unresponsive on ground at nursing home.  Pt was in dining room and found by staff.  Unresponsive for 1 min after found.  Pt cannot recollect events preceding fall but with some c/o HA and some neck/shoulder discomfort. NCHCT showed ~9mm L parietal SDH.  C-spine negative.  Imaging: CT head w/o contrast Acute left subdural hematoma measuring 1.5 cm maximal dimensions with leftward subfalcine herniation of 8 mm, downward transtentorial herniation with obliteration of the left suprasellar cistern, and uncal herniation. No fx, destructive infiltrative lesion involving the skull base.