Overview

• Brain death refers to the complete and irreversible loss of brain function.
• Can be diagnosed even if other vital functions (heart, lungs) are maintained artificially.

Diagnostic Criteria

1. Cessation of Brain Function

• No neuronal activity detectable.
• Confirmed via:
  • Imaging techniques (e.g., EEG, CT, MRI).
  • Absence of brainstem reflex responses:
    • Pupillary reflex.
    • Gag reflex.
    • Corneal reflex.
    • Oculocephalic reflex (doll’s eyes).
• No spontaneous respiratory effort:
  • Tested by removing ventilator support.
  • Absence of breathing indicates brainstem failure.

2. Cause of Brain Dysfunction

• Must be completely irreversible.
• Caused by trauma, stroke, tumor, or hypoxia that has caused extensive brain damage.
• The cause is thoroughly evaluated before confirming brain death.

3. Confirmation

• Typically, the diagnosis is made twice by different physicians.
• Ensures accuracy and avoids false diagnosis.

Additional Considerations

• The clinical picture must be consistent.
• No possibility of neurological recovery.
• Does not include coma or unresponsive wakefulness syndrome, which are potentially reversible.

Summary

• Brain death criteria involve loss of all brain functions and confirmatory testing.
• Once confirmed, organ donation and ethical considerations may follow.
• It remains a legal and medical standard for declaring death.