Determination of and Difficulties with Brain Death

  • James W. Bales
  • Louis J. KimEmail author


Brain death accounts for an estimated 1–2% of all deaths in the United States per year, and it will be encountered on a regular basis by any clinician who cares for patients with neurologic concerns. Despite worldwide acceptance of the concept of brain death, there remains considerable variation in determination and testing across countries and institutions. This can make brain death consideration confusing and stressful for both families and clinicians. The purpose of this chapter is to provide a general overview of brain death considerations and tools available to the clinician.


Ancillary testing Brain death End of life Apnea test Brain stem reflexes 



American academy of neurology


Central nervous system


Carbon dioxide


Cerebrospinal fluid


Computed tomography angiography




European union


Intensive care unit


Magnetic resonance imaging


Radionuclide imaging


Transcranial Doppler


Uniform determination of death act

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Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  1. 1.Department of Neurosurgery, Harborview Medical CenterUniversity of WashingtonSeattleUSA

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