Determination of cerebral perfusion by means of planar brain scintigraphy and99mTc-HMPAO in brain death, persistent vegetative state and severe coma

1992 ◽  
Vol 18 (2) ◽  
pp. 76-81 ◽  
Author(s):  
H. -P. Schlake ◽  
I. G. Böttger ◽  
K. -H. Grotemeyer ◽  
I. W. Husstedt ◽  
W. Brandau ◽  
...  
Author(s):  
Karl E. Misulis ◽  
E. Lee Murray

Neurologists are often asked to consult for determination of brain death or to advise families about prognosis and other aspects of the persistent vegetative state. Criteria for these conditions are discussed along with challenges in discussing them with families.


2020 ◽  
Vol 24 (3) ◽  
pp. 306-331
Author(s):  
Bas de Boer ◽  
Jonne Hoek ◽  

Death determination has long been a topic of intensive technoscientific and medical involvement. Due to advances in twentieth-century medical technology, the distinction between life and death has become less evident. Ambiguities appear when we start to use life-support technologies in order to save lives, bringing about “tragic artifacts” such as brain death and persistent vegetative state. In this paper we ask how this technoscientific and medical involvement shapes our understanding of death. We provide an overview of medical literature that has appeared on (brain) death determination, highlighting thereby the role that technologies played in its establishment. Subsequently, we develop three philosophical interpretations of technological death determination: With Agamben and Marcuse as the installation of political power; with Don Ihde as an existential choice for the inevitable; and with Jacques Derrida as an encounter with the ineradicable mystery of death. To conclude, we argue that technological death determination reveals an intrinsic, paradoxical connection between human’s technicity and its ignorance of death.


The Lancet ◽  
1993 ◽  
Vol 341 (8846) ◽  
pp. 696-697 ◽  
Author(s):  
D.J. Hill ◽  
D.W. Evans ◽  
LaurensP. White

Author(s):  
Bryan Young ◽  
Warren Blume ◽  
Abbyann Lynch

ABSTRACT:Brain death and the persistent vegetative state (PVS) share the following features: 1.) There is death of neurons in the brain; 2.) Both require an etiology which is capable of causing neuronal death. 3.) The potential for cognition is totally and permanently lost; 4.) Intensive medical support is usually withdrawn. In contrast, the diagnosis of brain death depends on death of the brainstem, while PVS implies permanent and total loss of forebrain function. While brainstem death can be diagnosed clinically, accurate prognosis in PVS requires additional investigation. Thus far, the EEG is the most specific test of neuronal function in the cerebral cortex. Brain death is equivalent to death, while PVS is not; management of the latter is more complex because of medical, social, ethical and legal factors.


Neurology ◽  
1983 ◽  
Vol 33 (8) ◽  
pp. 1027-1027 ◽  
Author(s):  
B. H. Holzman ◽  
R. G. Curless ◽  
G. N. Sfakianakis ◽  
C. Ajmone-Marsan ◽  
J. E. Montes

1997 ◽  
Vol 273 (3) ◽  
pp. H1291-H1298 ◽  
Author(s):  
T. B. Kuo ◽  
H. W. Yien ◽  
S. S. Hseu ◽  
C. C. Yang ◽  
Y. Y. Lin ◽  
...  

We compared the cardiovascular autonomic regulatory mechanisms between patients with brain death or under a persistent vegetative state and healthy volunteers, based on auto- and cross-spectral analysis of systolic blood pressure (SBP) and interpulse interval (PPI) signals. Brain-dead patients exhibited a significant reduction in the absolute and relative power of the low-frequency (LF; 0.04-0.15 Hz) component in both SBP and PPI spectra, along with appreciable decrease in the very low frequency (VLF; 0.004-0.04 Hz), LF, and high-frequency (HF; 0.15-0.4 Hz) power of the PPI signals. Patients in a persistent vegetative state exhibited a power of the VLF and LF component in the SBP spectrum that was comparable to that in healthy subjects, although a discernible reduction in the VLF, LF, and HF power of the PPI spectrum was manifested by the former group. Assessments with the magnitude of SBP-PPI transfer function and linear regression analysis of beat-to-beat fluctuations in SBP and PPI revealed a progressive decline in spontaneous baroreflex sensitivity from healthy subjects to patients in a persistent vegetative state or with brain death. We conclude that the vasomotor component of systemic arterial pressure signals and spontaneous baroreflex are highly correlated with the functional integrity of the brain stem.


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