Brain death is not the same as coma, because someone in a coma is unconscious but still alive. Brain death occurs when a critically ill patient dies sometime after being placed on life support. This situation can occur after, for example, a heart attack or stroke.
One is when the heart and lungs have stopped working. The other is when the entire brain has stopped working. The second is known as brain death. A patient cannot recover from brain death.
The brain stem also relays information to and from the brain to the rest of the body, so it plays an important role in the brain's core functions, such as consciousness, awareness and movement. After brain death, it's not possible for someone to remain conscious.
It is the complete stopping of all brain function and cannot be reversed. It means that, because of extreme and serious trauma or injury to the brain, the body's blood supply to the brain is blocked, and the brain dies. Brain death is death. It is permanent.
The three essential findings in brain death are coma, absence of brain stem reflexes, and apnea. An evaluation for brain death should be considered in patients who have suffered a massive, irreversible brain injury of identifiable cause.
But without a ventilator to keep blood and oxygen moving, this beating would stop very quickly, usually in less than an hour, Greene-Chandos said. With just a ventilator, some biological processes — including kidney and gastric functions — can continue for about a week, Greene-Chandos said.
After the first clinical exam, the patient should be observed for a defined period of time for clinical manifestations that are inconsistent with the diagnosis of brain death. Most experts agree that a 6 hour observation period is sufficient and reasonable in adults and children over the age of 1 year.
Patients may be misdiagnosed as “brain dead” if their doctors fail to order the necessary tests to determine whether or not they are aware of their condition and unable to communicate. Individuals who have suffered severe brain injuries need to be accurately diagnosed to receive the best possible care and treatment.
Physical examination, the apnea test, and ancillary tests can assess brain death. The physical examination includes the response to pain and assessment of brain stem reflexes. Loss of response to central pain occurs in brain death.
Can someone hear while on life support? It's hard to say for sure whether people on life support can hear their loved ones and healthcare providers. Small studies suggest it's possible. This probably depends on the level of sedation and how severe any possible brain injury is.
Brain Death Testing
These tests would confirm: the patient has no response to verbal or visual command, the patient is flaccid; pupils are unreactive and fixed; has no oculocephalic, gag, oculovestibular or corneal reflexes; and there is no spontaneous respiration.
The first organ system to “close down” is the digestive system. Digestion is a lot of work! In the last few weeks, there is really no need to process food to build new cells. That energy needs to go elsewhere.
Generally, most patients at a hospital do come out of a coma. Typically, a coma does not last more than a few days or couple of weeks.
Recently, two cases of reversible “brain death” have been reported from academic tertiary hospitals (Joffe et al. 2009; Webb and Samuels 2011). In addition to the above-mentioned dramatic, spontaneous full recovery from “brain death,” there are also many well-documented cases of “brain-death” survivors.
Family members may hold a false hope that the person is just comatose and could wake up with time or treatment. It is important for the medical staff members to fully explain that brain death is final, and that the person is dead and has no chance of ever regaining consciousness again.
One blood flow study was considered to have yielded a false-negative result. No patient recovered or survived. Conclusions: The clinical diagnosis of brain death is highly reliable when made by experienced examiners using established criteria. In this study, the accuracy was 100%.
Two senior doctors must perform separate tests at the bedside to determine whether the brain is working or not. These doctors check to see if the cranial nerves that pass through the brain stem and control all vital reflexes are working. They also check to see if the person: has any response to pain.
Brain death means that the brain stops functioning. People do not respond to any stimuli. No treatment can help, and once the diagnosis is confirmed, a person is considered legally dead. In the past, the idea of brain death was irrelevant because when the brain died, so did the rest of the body.
A variety of reflex movements have been reported in patients with brain death, such as plantar responses, muscle stretch reflexes, abdominal reflexes, and finger jerks (2). Because the aforementioned reflexes are spinal reflexes, the existence of such reflex movements does not preclude the diagnosis of brain death.
Brain death is death. A patient who is in a coma or persistent vegetative state typically has some brain stem function (which controls breathing) and possibly other brain function. When a person is brain dead, no part of the brain is functioning any longer.
A medical exam is the first step to diagnose a potential brain injury. Assessment usually includes a neurological exam. This exam evaluates thinking, motor function (movement), sensory function, coordination, eye movement, and reflexes. Imaging tests, including CT scans and MRI scans, cannot detect all TBIs.
Sudden death may occur as a result of rapid bleeding into any one or more of the intracranial compartments—extradural, subdural, subarachnoid, or intraventricular spaces—or into brain substance.
Contrary to previous notions that brain cells die within 5 to 10 minutes, evidence now suggests that if left alone, the cells of the brain die slowly over a period of many hours, even days after the heart stops and a person dies.
Several years ago, the autopsy report of a totally brain-dead patient named TK who was kept on life support for nearly twenty years was published in the Journal of Child Neurology. He remains the individual kept on life support the longest after suffering total brain failure.