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Subtotal Cerebral Circulatory Arrest With Preserved Breathing Activity: A Case Report
M A Wujtewicz1, A Szarmach2, K Chwojnicki3
1Department of Ophthalmology, Medical University of Gdansk, Gdansk, Poland.
Transplantation Proceedings
|February 27, 2016
Summary
Diagnosing brain death (BD) requires certainty. In a suspected brain death case, reflexes appeared due to extracranial blood supply, not intracranial function.
Area of Science:
- Neurology
- Critical Care Medicine
- Neurophysiology
Background:
- Brain death (BD) determination is critical for end-of-life care decisions and organ donation.
- Accurate BD certification requires unequivocal clinical findings to avoid diagnostic uncertainty.
Observation:
- A patient with suspected brain death showed reflexes during the BD assessment period.
- Initial angiography indicated no intracranial blood flow, a key criterion for brain death.
Findings:
- The observed reflexes originated from an extracranial blood supply.
- This extracranial supply preserved minimal lower brain stem function, mimicking neurological activity.
Implications:
- Highlights the importance of considering extracranial circulation in BD assessments.
- Emphasizes the need for comprehensive diagnostic protocols to prevent misdiagnosis of brain death.
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