Brain Death

Brain death “irreversible cessation of all function of the entire brain, including the cortex and brain stem, determined in accordance with accepted medical standards” CRITERIA FOR THE DIAGNOSIS OF BRAIN DEATH: • LOSS OF CEREBRAL CORTICAL FUNCTION o No spontaneous movement o Unresponsive to external stimuli • LOSS OF BRAIN STEM FUNCTION o Absent respiratory reflex (apnea test) o Absent cranial nerve reflexes (Gag or cough reflex to suction) o Pupillary light reflex ( no pupil constriction) o Corneal reflex ( no blinking with corneal touch) o Oculocephalic reflex ( doll’s eyes) o Oculovestibular reflex (cold caloric test) o Atropine resistance • SUPPORTING STUDIES

•

o Electroencephalography o Cerebral flow studies o Angiography o Transcranial Doppler examination o Xenon computed tomography scan First need to exclude other possible things that may mimics brain death e.g. hypothermia, drugs OD, toxins, infection, acid-base, and lytes abnormalities, Seizure disorder