4.12 Brain Death (Dropcho)

Question 0

how is a functional MRI useful when trying to determine if a patient is brain dead

Answer 0

5-10% of ptients will show imaging awareness.

(example: patient’s brain lit up with oxygen when she was asked to play tennis. she had no motor activity, but she did have brain activity in the areas of the brain linked to that activity)

Question 1

what is the UDDA definition of brain death

Answer 1

permanent cessation of clinical functioning of the whole brain is death of organism as a whole

(ZERO potential for any neuro recovery)

Question 2

describe to oculocephalics test

Answer 2

turn patient’s head to the side and up and down. if brainstem is intact their eyes roll in the opposite direction

Question 3

describe the oculocestibular test for the brainstem

Answer 3

put water into their ears. if brainstem is intact they will move their eyes toward the water

Question 4

what are the 4 neurologic criteria for declaring a patient brain dead

Answer 4

1. known and irreversible cause
2. absence of clinical function (no behavior responsiveness, no brainsteam function, apnea, total absence of brainstem reflexes)
3. exclusion of reversible/confounding conditions
4. appropriate period of observation

Question 5

Must a patient be brain dead to donate organs

Answer 5

No. patient can have irreversible cessation of circulator and respiratory functions.

Organs can be donated after circulatory determination of death

Question 6

Is a cerebral blood flow study more accurate than a clinical exam?

Answer 6

no. clinical exam is still the gold standard.

Question 7

A patient is suspected of being brain dead. When you push on their supraorbitals they have a posturing reflex. are they brain dead?

Answer 7

no.
movement, withdrawal, or posturing in response to a noxious stimulation is evidence that the person is not brain dead

(a brain dead person will still have motor reflexes)