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Lt Col Stanley A. Shatsky, MD; Lt Col Archimedes Ramirez, MD
Letterman Army Medical Center Presidio of San Francisco

JAMA. 1979;242(26):2844-2845.

	Since this article does not have an abstract, we have provided the first 150 words of the full text PDF and any section headings.

To the Editor.—

It was gratifying to see what M. Seth Hockman, MD, said (241:2783, 1979) regarding the successful neurological recovery of a 49-year-old patient with a panhemispheric acute subdural hematoma. We believe, however, that his point— what the present standard of neurosurgical practice is—must be much more strongly made to the medical community.

The author's first statement, "the development of fixed pupils following transtentorial herniation is such an ominous prognostic sign that only rarely have reports appeared that cite recovery from it," should be taken quite literally, that simply there have been few reports of recovery. This is not at all to say that the great majority of practicing neurosurgeons have not accumulated numerous patients who have recovered.

As US Army staff neurosurgeons, we have in the past two years had five patients recover from neurological deterioration as bad as or even worse than that described. The most recent . . . [Full Text PDF of this Article]

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