Brain death

Brain death
Other namesBrain stem death
A brain-dead patient. The patient can also be seen here executing the Lazarus sign.
SpecialtyNeurology, neurosurgery, palliative care, critical care medicine
ComplicationsTotal organ failure
CausesCardiac arrest, myocardial infarction, stroke, blood clot
Diagnostic methodStimulation testing, EEG, pupil reactivity test
TreatmentArtificial life support
PrognosisNone; brain death is irreversible
FrequencyRare
Deaths15,000 to 20,000

Brain death is the permanent, irreversible, and complete loss of brain function, which may include cessation of involuntary activity necessary to sustain life.[1][2][3][4] It differs from persistent vegetative state, in which the person is alive and some autonomic functions remain.[5] It is also distinct from comas as long as some brain and bodily activity and function remain, and it is also not the same as the condition locked-in syndrome. A differential diagnosis can medically distinguish these differing conditions.

Brain death is used as an indicator of legal death in many jurisdictions,[6] but it is defined inconsistently and often confused by the public.[7] Various parts of the brain may keep functioning when others do not anymore, and the term "brain death" has been used to refer to various combinations. For example, although one major medical dictionary considers "brain death" to be synonymous with "cerebral death" (death of the cerebrum),[8] the US National Library of Medicine Medical Subject Headings (MeSH) system defines brain death as including the brainstem. The distinctions are medically significant because, for example, in someone with a dead cerebrum but a living brainstem, spontaneous breathing may continue unaided, whereas in whole-brain death (which includes brainstem death), only life support equipment would maintain ventilation. In certain countries, patients classified as brain-dead may legally have their organs surgically removed for organ donation.[citation needed]

  1. ^ "Brain death". Encyclopedia of Death and Dying. Retrieved 25 March 2014.
  2. ^ Young, G Bryan. "Diagnosis of brain death". UpToDate. Retrieved 25 March 2014.
  3. ^ Goila, A.; Pawar, M. (2009). "The diagnosis of brain death". Indian Journal of Critical Care Medicine. 13 (1): 7–11. doi:10.4103/0972-5229.53108. PMC 2772257. PMID 19881172.
  4. ^ Machado, C. (2010). "Diagnosis of brain death". Neurology International. 2 (1): 2. doi:10.4081/ni.2010.e2. PMC 3093212. PMID 21577338.
  5. ^ Multi-Society Task Force on PVS (May 1994). "Medical aspects of the persistent vegetative state (1)". N. Engl. J. Med. 330 (21): 1499–508. doi:10.1056/NEJM199405263302107. PMID 7818633.
  6. ^ "Brain death". 20 October 2017.
  7. ^ Jones AH, Dizon ZB, October TW (August 2018). "Investigation of Public Perception of Brain Death Using the Internet". Chest. 154 (2): 286–292. doi:10.1016/j.chest.2018.01.021. PMC 7339235. PMID 29382473.
  8. ^ Elsevier, Dorland's Illustrated Medical Dictionary, Elsevier, archived from the original on 11 January 2014, retrieved 20 July 2015.