New guideline helps determine brain death in adults

Jun 07, 2010

A new national guideline, co-authored by a Henry Ford Hospital neurologist, has created an updated step-by-step process to help physicians better wade through the complex process of determining brain death in adult patients.

The guideline is set to appear in the June 8 issue of Neurology, the medical journal of the American Academy of Neurology (AAN).

The new AAN guideline is an improvement over the group's 1995 guideline, because it includes a check-list for physicians based on scientific research to help determine a diagnosis of brain death, says co-author Panayiotis N. Varelas, M.D., Ph.D., Director of the Neuro-Intensive Care Service, Henry Ford Department of Neurology & Neurosurgery.

"Many of the details of the clinical neurological examination to determine brain death cannot be established by evidence-based methods. Our goal was to develop a detailed brain death evaluation protocol that would be a useful tool for clinicians," he says.

Brain death occurs when the brain is no longer capable of sustaining the rest of the body's systems without advanced life support. It can result from a severe traumatic brain injury, stroke or prolonged CPR after cardiac arrest.

According to the new guideline, there are three signs that a person's brain has permanently stopped functioning. First, the person is comatose, and the cause of the coma is known. Second, all brainstem reflexes have permanently stopped working. Third, breathing has permanently stopped. A ventilator, or breathing machine, must be used to keep the body functioning.

The guideline describes several complex steps doctors must follow to diagnose brain death. It carefully reviewed the best way to demonstrate absence of breathing. The guideline also concludes that laboratory tests such as EEG or cerebral blood flow studies are not always necessary to come to a diagnosis. The guideline also makes clear that this complex process must be completed by a doctor with considerable skill and experience in diagnosing death.

Explore further: Know the brain, and its axons, by the clothes they wear

add to favorites email to friend print save as pdf

Related Stories

AAN guideline evaluates treatments for muscle cramps

Feb 22, 2010

A new guideline from the American Academy of Neurology recommends that the drug quinine, although effective, should be avoided for treatment of routine muscle cramps due to uncommon but serious side effects. The guideline ...

Recommended for you

Know the brain, and its axons, by the clothes they wear

Apr 18, 2014

(Medical Xpress)—It is widely know that the grey matter of the brain is grey because it is dense with cell bodies and capillaries. The white matter is almost entirely composed of lipid-based myelin, but ...

Turning off depression in the brain

Apr 17, 2014

Scientists have traced vulnerability to depression-like behaviors in mice to out-of-balance electrical activity inside neurons of the brain's reward circuit and experimentally reversed it – but there's ...

Rapid whole-brain imaging with single cell resolution

Apr 17, 2014

A major challenge of systems biology is understanding how phenomena at the cellular scale correlate with activity at the organism level. A concerted effort has been made especially in the brain, as scientists are aiming to ...

User comments : 0

More news stories

Less-schooled whites lose longevity, study finds

Barbara Gentry slowly shifts her heavy frame out of a chair and uses a walker to move the dozen feet to a chair not far from the pool table at the Buford Senior Center. Her hair is white and a cough sometimes interrupts her ...

Cancer stem cells linked to drug resistance

Most drugs used to treat lung, breast and pancreatic cancers also promote drug-resistance and ultimately spur tumor growth. Researchers at the University of California, San Diego School of Medicine have discovered ...

Making graphene in your kitchen

Graphene has been touted as a wonder material—the world's thinnest substance, but super-strong. Now scientists say it is so easy to make you could produce some in your kitchen.