Abstract
The declaration by a physician of brain death in a person requires a rigorous and exhaustive evaluation, not only of masquerading conditions but also at the same time a differential of the likely causes. Each step in the clinical evaluation and paraclinical ancillary test applications is beset by a number of errors. While using the American Academy of Neurology guidelines, it is important to consider each case individually and adjust the time of declaration of brain death accordingly, as well as the use of one or more ancillary brain death diagnostic tools. The use of diagnostic neuroimaging is evolving and new noninvasive magnetic resonance and computed tomography imaging techniques hold promise for assisting in this diagnosis in the future.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
References
Wijdicks EF. Determining brain deaths in adults. Neurology. 1995;45:1003–11.
Kollef MH, Bedient TJ, Isakow W, Witt CA. The Washington manual of critical care. Philadelphia: Lippincott Williams & Wilkins; 2007.
Kotsoris H, Schleifer L, Menken M, Plum F. Total locked-in state resembling brain death in polyneuropathy. Ann Neurol. 1984;16:150.
Danzl DF, Pozos RS. Accidental hypothermia. N Engl J Med. 1994;331:1756–60.
Yang KL, Dantzker DR. Reversible brain death: a manifestation of amitriptyline overdose. Chest. 1991;99:1037–8.
Grattan-Smith PJ, Butt W. Suppression of brainstem reflexes in barbiturate coma. Arch Dis Child. 1993;69:151–2.
Rowland LP. Locked-in syndrome. Merritt’s neurology. 11th ed. Philadelphia: Lippincott Williams & Wilkins; 2005.
Sedney CL, Coger BR, Bailes JE. Posterior fossa subdural hematoma resulting in locked-in syndrome. Neurosurgery. 2011;69(2):E497–500.
Practice parameters for determining brain death in adults (summary statement). The Quality Standards Subcommittee of the American Academy of Neurology. Neurology 1995; 45:1012–4.
Posner JB, Saper CB, Schiff ND, Plum F. Plum and Posner’s diagnosis of stupor and coma. 4th ed. Oxford: Oxford University Press; 2007.
Wijdicks EF, Varelas PN, Gronseth GS, et al. Evidence-based guideline update: Determining brain death in adults: Report of the Quality Standards Subcommittee of the American Academy of Neurology. Neurology. 2010;74:1911–8.
Burkle CM, Schipper AM, Wijdicks EF. Brain death and the courts. Neurology. 2011;76:837–41.
Author information
Authors and Affiliations
Corresponding author
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2013 Springer Science+Business Media New York
About this chapter
Cite this chapter
Keller, C.M., Chulpayev, B., Hoffmann, M. (2013). The Determination of Brain Death. In: Novitzky, D., Cooper, D. (eds) The Brain-Dead Organ Donor. Springer, New York, NY. https://doi.org/10.1007/978-1-4614-4304-9_3
Download citation
DOI: https://doi.org/10.1007/978-1-4614-4304-9_3
Published:
Publisher Name: Springer, New York, NY
Print ISBN: 978-1-4614-4303-2
Online ISBN: 978-1-4614-4304-9
eBook Packages: MedicineMedicine (R0)