Brain Death

Brain death is the total and irreversible loss of all brain function (including involuntary activity necessary to sustain life) and the condition under which the donation of vital organs most commonly takes place.

Brain death occurs when a person has an irreversible, catastrophic brain injury, which causes total cessation of all brain stem functions. Brain death is not coma or persistent vegetative state. 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.

Brain death is usually caused by:
  1. Trauma to the brain (i.e. severe head injury caused by a motor vehicle crash, fall or blow to the head)
  2. Cerebrovascular injury (i.e. stroke or aneurysm)
  3. Anoxia (i.e. when a patient is revived following drowning or heart attack, but not before a lack of blood flow/oxygen to the brain has caused brain death)
  4. Brain tumour

In India, brain stem death is determined in the hospital by a panel of four physicians that includes the treating physician, a physician representing the treating hospital, an independent specialist, and a neurologist or neurosurgeon. The tests are done twice with a gap of six hours to confirm death. This team is not associated with the transplantation team.

A brain dead patient looks to be asleep, is warm to touch and appears to breath, even though it is through the ventilator. The family, therefore, finds it difficult to understand the concept of brain stem death when this tragic situation is explained to them. Once the family has accepted that their loved one is dead, they are presented with the option of organ and tissue donation, in order to give life to others.

Brain Death Resource Material

I. Forms & Brief Documents
1. Diagnosing and Maintenance of Brain Death Organ Donor
2. Protocol For Diagnosis of Brain Death & Maintenance For Organ Transplantation - Dr.Mathew Joseph, CMC Vellore, India
3. Steps To Be Followed When A Diagnosis Of Brain Death Is Being Considered - Dr.Mathew Joseph, CMC Vellore, India
4. Medical Management of the Potential Donor - Dr.Mathew Joseph, CMC Vellore, India

II. Articles Related to Brain Death
1. Brain death Diagnosis and Management - Dr.Sunil Shroff
2. “Brain death” and “circulatory death”: Need for a uniform definition of death in India - Dr.Sunil Shroff, Dr. Sumana Navin
3. Current state of acceptance of brain stem death and organ donation in India - Dr. Sumana Navin, Ms. Sujatha Suriyamoorthi

III. Slides on Brain Death
1. Management of Brain Death - Dr.Sunil Shroff
2. Changing the Definition of Death - What do we know about brain death - Dr Sandeep Guleria, MS, DNB, FRCS, FRCSEd, MNAMS, Additional Professor, Dept. Of Surgery, AIIMS, New Delhi

Click here to view Brain Death Video

Click here to view FAQs on Brain Death

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