Diagnosis of Brain Death

Diringer, Michael N.; Steiner, Thorsten; Angstwurm, H

doi:10.1007/978-3-642-87602-8_21

Cited by 6 publications

(2 citation statements)

References 7 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…In Germany, the intervals oŸ repeat clinical evaluation are at least 12 hours in patients with p¡ and at least 72 hours in those with secondary brain [6,29,30]. Die Bedeutung der intraarte¡ AnNographie, die schon seit den 70er Jahren als aussagekr~iftigste Methode zur Feststellung des zerebralen Zirkulationsstillstands gilt [3,6,15,29], wird international immer ge¡ da diese invasive Untersuchung eine potentielle Gefahr ftir den Patienten darstellt. Die Feststellung des zerebralen Zirkulationsstillstands ist in Deutschland keine Indikation zur Durchfª einer Angiographie [30].…”

Section: Abstilact Determining Brain Death In Germanyunclassified

Aktueller Stand der Hirntoddiagnostik in Deutschland

Thömke

Weilemann

2000

Med Klin

View full text Add to dashboard Cite

Diagnosis of brain death requires definite evidence of an acute CNS catastrophe and exclusion of complicating medical conditions that may confound clinical assessment. Acute CNS catastrophe may be due to direct ("primary") brain damage (e.g., intracerebral hemorrhage, severe concussion, brain tumors), or indirect ("secondary") brain damage (e.g., cerebral hypoxia following cardio-pulmonary resuscitation). The cardinal findings in brain death are coma, absence of brainstem reflexes, and apnea. Persistence of these clinical signs determines brain death. In Germany, the intervals of a repeat clinical evaluation are at least 12 hours in patients with primary, and at least 72 hours in those with secondary brain damage. Electroencephalographically documented absence of electrical activity for at least 30 minutes or by means of transcranial Doppler ultrasonography or isotope angiography documented intracranial circulatory arrest also confirm brain death. Under such conditions, a repeat clinical evaluation is unnecessary in patients with clinical brain death signs. First of all, brain death is a clinical diagnosis. Confirmatory tests are not mandatory in most situations. In Germany, confirmatory tests are required in newborns, infants below the age of 2 years, and patients with infratentorial brain damage.

show abstract

Section: Abstilact Determining Brain Death In Germanyunclassified

Aktueller Stand der Hirntoddiagnostik in Deutschland

Thömke

Weilemann

2000

Med Klin

View full text Add to dashboard Cite

show abstract

“…After 5 days, when the CBZ level had declined to 15 µg/ml, these findings had normalized, except for prolongation in interpeak latency of BAEP. Reversible suppression of central evoked potentials are known to occur in phenytoin intoxication and hypothermia [2] but have not been described before in CBZ intoxication. There is experimental evidence that CBZ, which is chemically related to the tricyclic antidepressants, not only inhibits voltage-dependent sodium channels, but also interferes with nicotinic acetylcholine-associated ion channels and N-type voltage-dependent calcium-channels [9], so that extensive inhibition of impulse propagation and synaptic transmission in different systems may occur in overdose.…”

mentioning

confidence: 98%