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To the Editor:—
The case of cerebral abscess developing symptoms one day following a minor head injury reported by Drs. Winter and Shoshkes (JAMA176:1039 [June 24] 1961) calls for comment on the relationship of the trauma to the abscess. The authors were apparently satisfied that the trauma was etiologically significant, for alternate possibilities were not discussed. However, it seems incredible that such an abscess could have grown within 24 hours of its inception to a size sufficient to produce a hemiparesis. It seems very unlikely to me that the trauma was of any importance, except for the consideration that it might have precipitated or hastened the clinical expression of a previously silent abscess. Possibly the fall in which the patient struck her head was itself the first symptom of the abscess and the immediate result of a then unrecognized hemiparesis. Surely minor trauma cannot so easily be indicted
Roger C. Duvoisin. Brain Abscess and Head Trauma. JAMA. 1961;177(12):881. doi:10.1001/jama.1961.03040380059015