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At least 19 recordsLinked to original sources
PubMed1977

Brain death.

Brain death occurs whenever there is involvement of higher centers such as Cerebral Cortex and Thalamus (unresponsiveness and deep coma) and Brainstem and Basal ganglionic structures (loss of spontaneous respiration all cranial nerve, and postural reflexes). Involvement of Spinal Cord is less constant. Drug intoxication should be excluded. An electroencephalogram may be done but what is paramount is the physician's clinical judgment. The medico-legal implications of brain death is less complicated than it is generally presumed to be. It is extablishment of the legality of brain death concept that is crucial. This allows the physician to use his judgment to implement the law.

Brain Death↗
PubMed1976

Auditory brain-stem responses in brain death.

Auditory brain-stem responses were measured by far-field recording techniques in 27 patients fulfilling the criteria of brain death. The responses were either absent or consisted of the presence of just the initial component (Wave I). Wave I, when present, was of normal amplitude but prolonged in latency. Four patients were followed over several days from a state of coma with evidence of preserved brain-stem and cerebral functions to a clinical state compatible with brain death. Auditory brain-stem responses were initially intact and then showed a decrease in amplitude and a prolongation of latency of the later components until finally Wave I was alone. Auditory brain-stem responses are an objective measure of one of the sensory pathways traversing the brain-stem and can be used to evaluate the functional states of the brain-stem in patients in whom the question of brain death has been raised.

Adult↗
PubMed1976

Brain death.

Explore the source record for details and available documents.

Brain Death↗
PubMed1978

Pulsatile cerebral echo in diagnosis of brain death.

Conclusive diagnosis of brain death can be made by the demonstration of prolonged cessation of cerebral blood flow. This report describes a simple method to determine the presence or absence of the blood flow in the brain by recording the pulsatile midline echo on one channel of the electroencephalogram (EEG) or on any four-channel monitoring system in the intensive care unit. A firm transducer holder has been developed to eliminate artifacts caused by transducer motion, The pulsations of the midline echo are assumed to be the result of displacement of the midline structures by the arterial injection of each cardiac systole. Thus, the absence of these midline pulsatile echoes correlates with the absence of cerebral blood flow and, if the absence persists over 30 minutes in the presence of normal blood pressure, then the result is brain death. Twenty-eight cases of clinical brain death with electrocerebral silence of EEG and 18 obtained patients with various types of cerebral pathology were examined by the echo-pulsation technique. Twenty-six of the 28 cases showed no pulsation of the midline echo. The validity of the technique was documented in four cases by four-vessel cerebral angiogram.

Adolescent↗
PubMed1979

Diagnosis and management of brain death.

Finland was the first country in which brain death was legally accepted. Since 1975, 37 cases of brain death had been recorded in a university hospital in Finland, and these were reviewed. The cause for brain death was intracranial bleeding in 32 cases, other cerebrovascular disorder in two, and intracranial neoplasm in three. In 21 brain death was diagnosed clinically. In 16 cases confirmatory investigations (electroencephalography, cerebral angiography) were needed. After brain death had been established artificial support was withdrawn in 15 patients and organ transplantation was carried out in 10. In 12 patients, however, diagnosis of brain death did not influence management, though the heart stopped beating on average 25 hours after diagnosis. The Finnish criteria for brain death seem to be reliable and suitable for routine use.

Adolescent↗
PubMed1975

Criteria of brain death: review and comparison.

The concept of brain death has become important in law and medicine, replacing in some instances the concept of circulatory arrest as a definition of death. Yet, brain death has not been established as a clear clinical or pathologic entity, a point brought out here by comparison of criteria for identification. The need for more research is evident.

Angiography↗
PubMed1977

Management of seven stable levels of brain death.

We have presented the choices available in the management of seven representative kinds of brain death and partial death as well as their legal ramifications. Refinements of tests of brain functions and new methods of evaluating cerebral blood flow allow more and more accurate estimates of brain viability. Human qualities of life are directly related to how much and which parts of the brain are viable and are indistinguishable from life itself. The decision to end life support should at present remain with the attending physician. New statutes concerning brain death imply that irrefutable technical evidence is readily available to diagnose brain death, that brain death is as valid a sign of death as any former criteria, and that in certain situtations brain death must be used to pronounce death. From the medical practitioner's viewpoint, we believe that a brain death law would rarely be useful and that community and national customs concerning heroic efforts would be sufficient. We do support a simple acknowledgement by statute that brain death may be a cause for determining death. The legal need for determining a precise time of death is understandable, but premature and restrictive definitions based on a rapidly evolving technology will create many problems.

Brain↗
PubMed1976

[Clinicopathological studies of the vegetative state--distinction between the vegetative state and brain death].

10 cases showing vegetative state and 2 cases of brain death due to severe brain damage were observed and the differences of clinicopathological findings between both states were discussed. The cases of vegetative state can be divided into three groups, first is widespread lesion in the cerebral cortex, second is in the cerebral white matter and third is in the brain stem. While, the diffuse whole brain damage including the vegetative center of the central nervous system causes brain death. We should like to emphasize that the most important structure to maintain the human life is the vital center in the brain stem, and that a human being, in whom only those function can be preserved, is possible to be alive as vegetative state. Prognostic value of the EEG indicating quality of survival noted in early stage after severe brain damage has not so important as the flat EEG revealed in brain death.

Adult↗
PubMedDate not supplied

Computerized axial tomography in brain death.

Two patients with the diagnosis of brain death were evaluated with computerized axial tomography (CAT). After intravenous infusion of 30% Conray there was no visualization of the intracranial vasculature (circle of Willis). The second patient also had an isoelectric EEG. A third patient with an intracerebral lesion similar to the other cases but without diagnosis of brain death, showed good visualization of the circle of Willis. Therefore, contrast-enhanced CAT scans can be used as another diagnostic aid to confirm brain death.

Aged↗