brain, spinal cord, and nerve disorders
Brain Death
Diagnosis of Brain Death
A doctor's evaluation based on specific criteria Occasionally other tests, usually to make organ donation possible There are specific criteria for diagnosing brain death. They include Checking for and correcting all treatable problems that could alter brain function and thus result in a misdiagnosis of brain death (such as very low body temperature, very low blood pressure, or very low blood levels of certain substances such as sugar and sodium or an overdose of a sedative) Identifying and treating any condition that could cause coma and irreversible loss of all brain function Testing the person's reflexes (such as the gag reflex, triggered by touching the back of the throat) and observing no response (the person does not grimace, move, or otherwise react) Testing the eyes and observing no reaction to light Testing breathing by taking the person off the ventilator and observing that the person makes no attempt to breathe Doctors should maintain communication with the family or attempt to notify the person's next of kin or a close friend of their findings as soon as the diagnosis and evaluation of brain death begins. Doctors typically recheck the criteria 6 to 24 hours later to confirm the person's lack of response. All of the following must be done: All treatable problems that could be misdiagnosed as brain death are ruled out. A comprehensive neurologic examination has been done. The required testing has been done. In adults, brain death can be confirmed after a second check is done 6 to 24 hours later. For children, some states advise doctors to do two separate examinations, separated by at least 48 hours. Occasionally, when results of the initial evaluation are uncertain or the evaluation cannot be completed, doctors use certain diagnostic tests to help them diagnose brain death. Establishing the diagnosis of brain death quickly may be especially important when organ transplantation is planned—for example, after catastrophic head injuries (as may occur in car crashes). The tests include Electroencephalography (EEG—a recording of the brain’s electrical activity): This test shows no brain waves when a person is brain dead. Imaging tests can be used to detect blood flow to the brain: No blood flows to the brain when a person is brain dead. Imaging tests include Positron Emission Tomography (PET) (PET), 