19 August 2011

A fatal blow to the brain

In the case of a brain injury, death may in fact occur hours before the heart stops beating. When is someone brain dead?

A beating heart and breathing are synonymous with life. However, the moment of actual death may not necessarily be the moment when the heart stops beating, or when breathing ceases. In the case of a brain injury, death may in fact occur hours before the heart stops beating.

Some of these fears should be allayed by the requirement that two experienced doctors (one doctor with at least five years of experience - preferably a neurologist or neurosurgeon) are obliged to carry out a series of medical tests independently and according to international criteria. The results of all these tests should be "negative" for any sign of brain activity.

  • Absent pupil reflex: fixed dilated pupils not constricting when light is shone directly on the eye;
  • No cornea reflex: the eyes and eyelids don’t move when touched with a piece of gauze;
  • No eye movement when cold water is put in the ears. A doctor puts 20ml of ice water on the eardrums, and watches the patient’s eyes carefully. If the eyes move, the patient isn’t brain dead;
  • No movements in the face will be detected when a painful stimulus is applied to different areas of the body;
  • The gag reflex is absent: no gagging motion when slight pressure is applied to the throat;
  • The coughing reflex is absent when the ventilation tube in the throat is inserted or removed;
  • No pain reflex or any sign that the patient experiences pain when the doctor hurts his face;
  • No eye movement when the patient's head is being turned from side to side.


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