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[Intracranial pressure and brain death].

E Scherzer1

  • 1Neurotraumatologischen Rehabilitationszentrum Wien-Meidling, Allgemeinen Unfallversicherungsanstalt Osterreichs.

Wiener Medizinische Wochenschrift (1946)
|January 1, 1990
PubMed
Summary

Cerebral death, irreversible brain destruction, is diagnosed by monitoring intracranial pressure. A 15-20 minute circulatory arrest confirms brain death for organ donation.

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Area of Science:

  • Neurology
  • Critical Care Medicine
  • Neurosurgery

Context:

  • Cerebral death results from irreversible, malignant increases in intracranial pressure.
  • Routine monitoring of intracranial and systemic blood pressure in deep coma patients is crucial.

Purpose:

  • To identify the precise moment of complete cessation of cerebral perfusion.
  • To confirm the irreversibility of cerebral circulatory arrest.
  • To establish diagnostic criteria for brain death, facilitating organ transplantation.

Summary:

  • Cerebral death is defined as the isolated destruction of the entire brain due to critically elevated intracranial pressure.
  • Continuous blood pressure monitoring helps detect and confirm the standstill of cerebral perfusion.
  • A 15-20 minute period of circulatory arrest is recommended before definitive diagnosis, such as cerebral arteriography, to ensure brain death confirmation and enable organ explantation.

Impact:

  • Accurate diagnosis of brain death is essential for timely organ procurement for transplantation.
  • Understanding the timeline of ischemic damage (8-10 minutes) is critical for diagnosis.
  • While epidural intracranial pressure measurement has limitations, it aids in timing diagnostic angiography to expedite brain death determination.

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