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November 1968


Author Affiliations

Gundersen Clinic, Ltd. La Crosse, Wis

Arch Neurol. 1968;19(5):543. doi:10.1001/archneur.1968.00480050113014

To the Editor.  —Brinksmanship, the bravado of men, has been amply demonstrated again in recent weeks with Russia's invasion of Czechoslovakia and Jaffe, Librot, and Bender's1 report of "medical" treatment of chronic subdural hematoma. Lack of treatment is hardly therapy; and in some instances it should be considered outside the usual standard of treatment in a community!We know of one large public hospital where the last six patients with subdural hematoma have been managed into coma by this ill-bravado. Only two of the patients survived when the neurosurgeons were allowed to intervene after the patients were in extremis.Within 48 hours in patients who have not been allowed to deteriorate into advanced neurologic decompensation most signs and symptoms of subacute or chronic subdural hematoma are ameliorated by the simple, safe tactic of burr holes. Burr holes are by far the safest surgical procedure known in competent hands.

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