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July 1981

Chronic Bilateral Subdural Hematomas First Observed With Gait Dysfunction and Impotence

Author Affiliations

Department of Neurology Letterman Army Medical Center San Francisco, CA 94129

Arch Neurol. 1981;38(7):472. doi:10.1001/archneur.1981.00510070106033

To the Editor.—  Although it has long been recognized that micturition and defecation are under cerebral control,1-3 it is not clinically well established that penile erection has an analogous center. My observations of the following patient with chronic subdural hematomas may give clinical support to the existence of a cerebral control center specifically related to the control of male sexual function.

Report of a Case.—  A robust 83-year-old widower, who was planning to remarry and claimed to have excellent sexual function, was first seen for a medical evaluation 56 days after sustaining a blow to the head in an automobile accident, which caused him to lose consciousness. His chief complaint was impotence that began a few weeks after the accident and, more recently, progressive difficulty with ambulation. He denied bowel or bladder dysfunction although he experienced an episode of urinary incontinence on the evening after hospital admission. Neurological examination

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