Neurosurgery – decision to operate

In patients with a variety of acute neurosurgical ‘injuries’ the absence of pupillary responses, and failure of mannitol (or similar agent) to alter this, is often used as evidence for futility and subsequent refusal of surgical intervention (+/- transfer, if from a DGH). Is this a reasonable? A – A neurological “injury” worth mentioning, although not a neurosurgical one, is … More Neurosurgery – decision to operate