Bedside procedures in the diagnosis of brain death

Abstract

Thirteen different tests were performed on 42 patients in the state of brain death. Some of these tests are well known and widely utilized, such as elect roencephalography, carotid and vertebral arteriography, brain scanning and gamma camera, and echoencephalography. More sophisticated tests such as measurement of cerebral blood flow, cerebral oxygen consumption and intracranial pressure are less accurate but may assist in an earlier forecast of brain death. Three new procedures, electronystagmography, intrathecal injection of I-labelled serum albumin and brain temperature tests, are also described. The poor specificity of the caloric test and the high reliability of the atropine test are stressed. It is concluded that a selection of simple, rapid, bedside tests have been shown to be entirely adequate in confirming the clinical diagnosis of brain death.