The auditory pathology of brain death as revealed by auditory evoked potentials

A case of brain death is reported in which the auditory brainstem response, middle latency component, and slow vertex response were recorded before and after the cessation of cortical activity, and in which histological examination of the temporal bone and central auditory pathways was performed post mortem. Brain death of at least 48 hours' duration was demonstrated by neurological examination, flat electroencephalographic recording, and persistent absence of auditory evoked responses. The postmortem examination was performed 3 hours after death. The pathological studies of the whole length of the auditory pathway revealed total autolysis of the organ of Corti, marked cell loss in the dorsal cochlear nucleus, and moderate cell loss in other nuclei of the central auditory pathway. It should be considered that total autolysis of the organ of Corti and severe cell loss of the cochlear nucleus may occur if the auditory brainstem response becomes absent in comatose patients.