Evaluation Of Brain Death Research Articles

An alternative apnea test for the evaluation of brain death

Annals of NeurologyVolume 30, Issue 6 p. 852-853 Letter An alternative apnea test for the evaluation of brain death David H. Gutmann MD, PhD, David H. Gutmann MD, PhD Department of Neurology, The Hospital of the University of Pennsylvania, Philadelphia, PASearch for more papers by this authorPaul L. Marino MD, PhD, Paul L. Marino MD, PhD Mount Sinai Medical Center Pulmonary-Critical Care Division, New York, NYSearch for more papers by this author David H. Gutmann MD, PhD, David H. Gutmann MD, PhD Department of Neurology, The Hospital of the University of Pennsylvania, Philadelphia, PASearch for more papers by this authorPaul L. Marino MD, PhD, Paul L. Marino MD, PhD Mount Sinai Medical Center Pulmonary-Critical Care Division, New York, NYSearch for more papers by this author First published: December 1991 https://doi.org/10.1002/ana.410300620Citations: 5AboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL No abstract is available for this article.Citing Literature Volume30, Issue6December 1991Pages 852-853 RelatedInformation

Usefulness of EEG in the evaluation of brain death in children: the pros

The confirmatory tests most frequently used in the evaluation of the cerebral function are cerebral blood flow (CBF) studies and the EEG. Absence of CBF by 4-vessel angiography is considered to be the most reliable test to determine cerebral death but the logistics of obtaining this study preclude its use. The accuracy and reliability of the EEG in the diagnosis of brain death have been frequently questioned (Drake et al. 1986; Vernon and Holtzman 1986) despite the existence of studies

Usefulness of EEG in the evaluation of brain death in children: the cons

The research literature about ‘brain death’ is largely characterized by biomedical, bioethical and legal writing. This has led to overlooking wider but no less pertinent social, historical and cultural understandings about death. By ignoring the work of other social and clinical colleagues in the study of dying, the literature on the determination of death has become unnecessarily abstract and socially disconnected from parallel concerns about death and dying. This has led, and continues to lead to, incomplete suggestions and narrow discussions about the nature of death as well as an ongoing misunderstanding of general public and health care staff responses to brain death criteria. This paper provides a sociological outline of these problems through a review of the key literature on the determination of death.

Book reviews

The aim of this publication is to produce state-of-the-art reviews in a variety of areas encompassed by the field of nuclear medicine. It succeeds in this and contains some excellent reviews. However, with one exception, the 10 articles which make up the book are written by authors practising in the USA and, inevitably, its emphasis on some techniques reflects North American rather than British practice. The chapter on “Radionuclide evaluation of brain death”, for instance, would be unlikely to be included in any review originating in Britain.

Neuromonitoring.

Neuromonitoring--the continuous or intermittent observation of nervous system functions--has become a field of interdisciplinary interest. Basically there are two major applications of neuromonitoring: in the operating theatre and the neurological or neurosurgical intensive care unit. Evoked potential recording, intracranial pressure measurement, serial EEG recording, cerebral blood flow measurement and ultrasound techniques have all been used as monitoring methods. The application of these techniques for operations, intensive care and the evaluation of brain death will be described.

Digital subtraction angiography (DSA) in the evaluation of brain death. A comparison of conventional cerebral angiography with intravenous and intraarterial DSA.

Demonstration that intracranial circulation has ceased is the ultimate proof of brain death. This study was performed to evaluate digital subtraction angiography (DSA) compared with conventional cerebral angiography in the diagnosis of brain death. Intravenous as well as intraarterial DSA was found suitable in the diagnosis of arrested intracranial circulation.

The clinical role of somatosensory evoked potential studies: a critical appraisal.

The clinical utility and limitations of somatosensory evoked potential (SEP) studies are reviewed. Somatosensory evoked potentials may help to identify a lesion in the sensory pathways, but do not indicate its nature. In multiple sclerosis subjects, the SEP findings may help to establish that there is a multiplicity of lesions, but multimodality evoked potential abnormalities may occur in other disorders. Somatosensory evoked potential abnormalities do not reflect either the severity or the prognosis of cervical spondylosis and do not reliably permit early recognition of the totality of traumatic cord lesions, while the role of SEPs in monitoring cord function intraoperatively awaits definition. Somatosensory evoked potentials do not reliably indicate the individual prognosis after severe head injury, and discrepancies in published findings suggest that their use in the evaluation of brain death is premature. In hereditary spinocerebellar degenerations, SEP abnormalities may reflect central or peripheral pathology. Somatosensory evoked potentials can be used to determine conduction velocity in peripheral nerves and to identify inaccessible proximal lesions of these nerves, but the findings may lead to misleading conclusions about brachial plexus lesions, especially if pre- and postganglionic lesions coexist.

Evaluation of brain death by contrast-enhanced computerized cranial tomography

Evaluation of brain death by contrast-enhanced computerized cranial tomography

Drug-Associated Isoelectric EEGs

AN ISOELECTRIC EEG is often regarded as the definitive feature of death. However, some pharmaceuticals have been reported to be associated with an isoelectric EEG in patients who subsequently showed neurologic and EEG improvement. A literature review was conducted to identify such agents. This information is of importance in the care of patients with undiagnosed coma or drug overdose who may be candidates for organ donation if true "brain death" can be certified. Some agents were found to produce only relatively short periods of cerebral silence but are included here because of the inherent tragedy of a "false-positive" brain-death evaluation. Those drugs previously reported to be associated with isoelectric periods of any duration include the following: barbiturates,^1-7methaqualone,^1,6,7diazepam,¹mecloqualone,¹meprobamate,^1,3and trichloroethylene.^1,8 Other drugs commonly ingested in toxic quantities but not found to produce an isoelectric EEG as a primary drug effect are