3D EEG and Clinical Evidence of Brain Dying. Preliminary Report

Abstract

Determination of brain dying means reversible or irreversible injury to the brain, including the brainstem. Current guidelines rely on clinical examination including the proof of coma, absent brain stem reflexes, and apnoea test. Neurophysiological testing using electroencephalography and evoked potentials — somatosensory evoked potentials and brainstem auditory evoked potential could have been helpful in the final diagnostic brain death conclusion, but the diagnostic accuracy of these methods in the last years has revealed controversies. Here, we present data on quantitative EEG signal evaluation (qEEG) by a 3-dimensional brain mapping (3D BM) as developing tool to clarify whether the transverse and anterior posterior coherences such as connectivity indices may demonstrate connection in transversal or anterior posterior dimensions with «wavelet transformation» and if the 3D BM visualization of the of representative EEG signals may improve informative value of EEG signals quantification when evaluating the brain dying.The purpose of our work is to provide an update on the evidence and controversies on the use of EEG for determining brain dying and raise discussion on EEG applications to improve the transplantation program.Results. We analyzed the EEG records of 10 patients admitted for cardiopulmonary resuscitation (CPR) during September, 2017 — August, 2018. Data from one patient, ŽM, 33 years old, after haemorrhagic shock (August 2018) were analyzed in details. Quantitative EEG dynamics by images and clinical course of brain dying were monitored prior and after the amantadine sulfate intravenous administration for brain revival. Data demonstrated the ability of brain to survive; the cause of final brain death was heart failure.Conclusion. Data confirm the hope for survival of the brain in a coma and demonstrate brain capability to keep functionally optimal state as a potential for a good social adaptation.