TO THE EDITOR: Jüttler and colleagues (March 20 issue)1 provide important and sobering statistics on outcomes after space-occupying ischemic strokes that are managed surgically and nonsurgically in older adults. To translate these findings to the bedside, a physician is forced to ask: How do I explain the potential range of outcomes of a procedure fairly and rapidly without predetermining the outcome? In the corresponding editorial, Ropper2 reminds readers about the importance of this moment and the tendency for many patients and families to “take a chance on surgery.” We argue that it is crucial — and in fact, ethically imperative . . .