American Research Journal of Clinical Case Reports

Neurosurgical patients face dire outcomes infringing upon their functional capacity. Often, the impairment of a neurosurgical patient may be so severe patients will indefinitely require assistance with the majority of activities of daily living. These patients may be left unable to communicate, be left largely unable to interact with their environment, and may very well be unable to comprehend the world around them to their previous extent. Over decades of exposure to such tragic outcomes, it is not uncommon for neurosurgeons to ponder if these patients would have been better off dead. Within the common situation of a severe acute subdural hematoma, there is often controversy amongst the surgical team as to whether an operation should occur as the patient is often left severely impaired at best. To further explore the ethics of when to operate, the case of a severe acute subdural hematoma is used to guide discussion and ultimately suggest approaches in practice.