Recovery From Fixed Pupils Following Acute Subdural Hematoma

To the Editor.—  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. In 1970 Brendler and Selverstone¹ described nine cases of recovery from decerebration and fixed pupils secondary to expanding supratentorial mass lesions, approximately 50% of which were postoperative hematomas. This report describes another case in which recovery followed an acute traumatic subdural hematoma.

Report of a Case.—  A 49-year-old alcoholic staggered into the emergency room intoxicated. He had a laceration over the right eye. His vital signs were normal, and the patient was oriented. The pupils were equal, round, and reactive; reflexes were symmetrical. The gait was unsteady. Skull x-ray films were normal. The pineal was not adequately visualized to determine shift. The patient was admitted to the special care unit, where five hours after admission, he was observed by the nurse