96F 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.  Taken to [**Hospital1 1218**]
   where NCHCT preformed at 18:32 showed ~9mm L parietal SDH.
   C-spine negative.  
   
   Family / Social  history:
    dementia, HTN, afib, CAD
   SURGICAL Hx:  unknown
   .
   SOCIAL Hx:  Daughter serves as HCP; Pt currently DNR/DNI except for
   elective procedure (****SEE CLARIFICATIOIN BELOW****).
   .
   ALLERGIES:  NKDA

   Physical Examination
   General Appearance: No acute distress, Thin
   Eyes / Conjunctiva: PERRL, Conjunctiva pale
   Head, Ears, Nose, Throat: Normocephalic, Poor dentition
   Lymphatic: Cervical WNL, Supraclavicular WNL
   Cardiovascular: (S1: Normal), (S2: Normal)
   Peripheral Vascular: (Right radial pulse: Present), (Left radial pulse:
   Present), (Right DP pulse: Diminished), (Left DP pulse: Diminished)
   Respiratory / Chest: (Expansion: Symmetric), (Breath Sounds: Clear :
   bialterally)
   Abdominal: Soft, Non-tender, Bowel sounds present
   Extremities: Right: Absent, Left: Absent
   Skin:  Warm
   Neurologic: Attentive, Follows simple commands, Responds to: Verbal
   stimuli, Oriented (to): A+O x 2, Movement: Not assessed, Tone: Not
   assessed

   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