Brain stem death (patient information): Difference between revisions
Jump to navigation
Jump to search
No edit summary |
|||
| Line 5: | Line 5: | ||
{{CMG}}; Jinhui Wu, MD | {{CMG}}; Jinhui Wu, MD | ||
==Overview== | |||
[[Brain stem]] is the inner part of the brain that is connected to the spinal cord. It is responsible for regulating most of the automatic functions of the body that are essential for life, including breathing, heartbeat, blood pressure and swallowing. Further more, the brain stem plays a vital role in core functions such as consciousness, awareness and movement. Brain stem death means that the brain stem stops working, not sending messages to the body to control such core functions, at the same time, not receiving messages back from the body. Once brain stem occurs, there is no chance to recover. | |||
==What | ==What are symptoms of Brain stem death?== | ||
[[ | *No pupillary response to light | ||
*No blanking on corneal touch | |||
*No eye movement on caloric testing | |||
*No grimacing on paiful stimuli | |||
*No [[cough reflex]] or [[gag reflex]] | |||
*No [[vestibulo-ocular reponse]] | |||
== | ==What causes Brain stem death?== | ||
:*Severe [[brain swelling]] after a serious fall or traffic accident or [[trauma]] | :*Severe [[brain swelling]] after a serious fall or traffic accident or [[trauma]] | ||
:*Massive [[cerebral hemorrhage]] | :*Massive [[cerebral hemorrhage]] | ||
:*Severe or long time of [[anoxia]] | :*Severe or long time of [[anoxia]] | ||
== | ==Diagnosis== | ||
A series of strict tests need to be carried out by two senior doctors who are not members of transplant team. The tests are done at the patient's bedside. These tests are frequently repeated to confirm that | A series of strict tests need to be carried out by two senior doctors who are not members of transplant team. The tests are done at the patient's bedside. These tests are frequently repeated to confirm that the patient's brain stem has stopped working. All the following criteria need to be met before brain stem death can be pronounced. | ||
*Clinical tests for absent brain stem reflexes | *Clinical tests for absent brain stem reflexes | ||
:*No pupillary response to light | :*No pupillary response to light | ||
| Line 33: | Line 39: | ||
:*Reconnect ventilator | :*Reconnect ventilator | ||
== | ==Diseases with similar symptoms== | ||
:*[[Persistent vegetative state]] ([[PVS]]): Patients in a PVS has no feeling mental distress, or physical pain, or awareness of the surroundings. The difference between PVS and brain stem death is whether the core functions are affected. For patients with PVS, there is a slim chance to recover.But for the patients with brain stem death, there is no chance once their brain stem has died. All of the core functions of the body have stopped working and can never be restarted. | :*[[Persistent vegetative state]] ([[PVS]]): Patients in a PVS has no feeling mental distress, or physical pain, or awareness of the surroundings. The difference between PVS and brain stem death is whether the core functions are affected. For patients with PVS, there is a slim chance to recover.But for the patients with brain stem death, there is no chance once their brain stem has died. All of the core functions of the body have stopped working and can never be restarted. | ||
==Where to find medical care for brain stem death?== | ==Where to find medical care for brain stem death?== | ||
[http://maps.google.com/maps?f=q&hl=en&geocode=&q={{urlencode:{{#if:{{{1|}}}|{{{1}}}|brain stem death}}}}&sll=37.0625,-95.677068&sspn=65.008093,112.148438&ie=UTF8&ll=37.0625,-95.677068&spn=91.690419,149.414063&z=2&source=embed Directions to Hospitals Treating brain stem death] | [http://maps.google.com/maps?f=q&hl=en&geocode=&q={{urlencode:{{#if:{{{1|}}}|{{{1}}}|brain stem death}}}}&sll=37.0625,-95.677068&sspn=65.008093,112.148438&ie=UTF8&ll=37.0625,-95.677068&spn=91.690419,149.414063&z=2&source=embed Directions to Hospitals Treating brain stem death] | ||
[[Category:Medical ethics]] | |||
[[Category:Neurology]] | |||
[[Category:Emergency medicine]] | |||
[[Category:Intensive care medicine]] | |||
[[Category:Mature chapter]] | |||
{{WH}} | {{WH}} | ||
{{WS}} | {{WS}} | ||
Revision as of 18:33, 1 August 2011
For the WikiDoc page for this topic, click here
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Jinhui Wu, MD
Overview
Brain stem is the inner part of the brain that is connected to the spinal cord. It is responsible for regulating most of the automatic functions of the body that are essential for life, including breathing, heartbeat, blood pressure and swallowing. Further more, the brain stem plays a vital role in core functions such as consciousness, awareness and movement. Brain stem death means that the brain stem stops working, not sending messages to the body to control such core functions, at the same time, not receiving messages back from the body. Once brain stem occurs, there is no chance to recover.
What are symptoms of Brain stem death?
- No pupillary response to light
- No blanking on corneal touch
- No eye movement on caloric testing
- No grimacing on paiful stimuli
- No cough reflex or gag reflex
- No vestibulo-ocular reponse
What causes Brain stem death?
- Severe brain swelling after a serious fall or traffic accident or trauma
- Massive cerebral hemorrhage
- Severe or long time of anoxia
Diagnosis
A series of strict tests need to be carried out by two senior doctors who are not members of transplant team. The tests are done at the patient's bedside. These tests are frequently repeated to confirm that the patient's brain stem has stopped working. All the following criteria need to be met before brain stem death can be pronounced.
- Clinical tests for absent brain stem reflexes
- No pupillary response to light
- No blanking on corneal touch
- No eye movement on caloric testing
- No grimacing on paiful stimuli
- No cough reflex or gag reflex
- No vestibulo-ocular reponse
- Test for confirmation of persistent apnoea. The procedure is the following:
- Preoxygenation with 100% oxygen for 10 minutes
- Allow PaCO2 to rise above 5.0 kPa before test
- Disconnect from ventilator
- Maintain adequate oxygenation during test
- Allow PaCO2 to climb above 6.65 kPa
- Confirm no spontaneous respiration
- Reconnect ventilator
Diseases with similar symptoms
- Persistent vegetative state (PVS): Patients in a PVS has no feeling mental distress, or physical pain, or awareness of the surroundings. The difference between PVS and brain stem death is whether the core functions are affected. For patients with PVS, there is a slim chance to recover.But for the patients with brain stem death, there is no chance once their brain stem has died. All of the core functions of the body have stopped working and can never be restarted.