Clinical deterioration prior to brain death related to progressive intracranial hypertension
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The clinical course preceding brain death was observed in 62 patients by frequent clinical examinations; in 44 of them the intracranial pressure was recorded continuously. In 53 patients the diagnosis of brain death was confirmed by demonstration of cessation of the brain circulation using four-vessel cerebral angiography. Sudden and gradual deterioration was found as the intracranial pressure rose to the level of the arterial blood pressure. After arteriographic documentation of brain death spinal reflexes were present in 80 per cent of the patients.
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