DEPARTAMENT OF NEUROLOGY AND NEUROSURGERY
Experimental Neurology Branch

Morte EncefálicaApnéia na Morte EncefálicaIschemic Penumbra and Brain DeathMorte Encefálica: Repercurssão Internacional

Implications of ischemic penumbra for the diagnosis of brain death:
Apnea testing may induce rather than diagnose death 

References

  1. Beecher HK, Adams RD, Barger AC, Curran WJ, Denny-Brown D, Farnsworth DL, Folch-Pi J, Mendelsohn EI, Merrill JP, Murray J, Potter R, Schwab R, Sweet W. A definition of irreversible coma: Report of the Ad Hoc Committee of the Harvard Medical School to Examine the Definition of Brain Death. JAMA. 1968;205:85-88.
  2. President's commission for the study of ethical problems in medicine and biomedical and behavioral research. Guidelines for the determination of death: report of the medical consultants on the diagnosis of death. JAMA. 1981;246:2184-2186.
  3. Wijdicks EFM. Determining brain death in adults. Neurology. 1995; 45:1003-1011.
  4. Schrader H, Krogness K, Aakvaag A, Sortland O, Purvis K. Changes of pituitary hormones in brain death. Acta Neurochir. 1980;52:239-248.
  5. Bücheler E, Käufer C, Düx A. Zerebrale Angiographie zur Bestimmung des Hirntrodes. Fortschr Röntgenstr. 1970;113:278-296.
  6. Bergquist E, Bergström K. Angiography in cerebral death. Acta Radiol, Diag. 1972; 12:283-288.
  7. Astrup J, Siesjö BK, Synon L. Thresholds in cerebral ischemia - the ischemic penumbra. Stroke. 1981;12:723-725.
  8. De Reuck J, Leys D, De Keyser J. Is positron emission tomography useful in stroke? Acta Neurol Belg. 1997;97:168-171.
  9. Fisher M. Characterizing the target of acute stroke therapy. Stroke. 1997;28:866-872.
  10. Kennedy C, Sakurada O, Shinohara M, Jehle J. Sokoloff L. Local cerebral glucose utilization in the normal conscious Macaque monkey. Ann Neurol 1978;4:393-301.
  11. Kosteljanetz M, ØhrstrØm JK, SkjØdt S, Teglbjærg PS. Clinical brain death with preserved cerebral arterial circulation. Acta Neurol. Scand. 1988;78:418-471.
  12. Truog RD. Is it time to abandon brain death? Hastings Cent Rep. 1997;27:29-37.
  13. Bernat JL. How much of the brain must die in brain death? J Clin Ethics. 1992;3:21-26; discussion 27-28.
  14. Shewmon DA. The probability of inevitability: the inherent impossibility of validating criteria for brain death or 'irreversibility' through clinical studies. Stat Med. 1987;6:535-553.
  15. Reilly PM, Anderson HL, Sing RF, Schwab CW, Bartlett RH. Occult hypercarbia. An unrecognized phenomenon during percutaneous endoscopic tracheostomy. Chest. 1995;1071760-1763.
  16. Miller JD. Physiology of trauma. Clin Neurosurg. 1982;29:103-130.
  17. Miller JD, Butterworth JF, Gudeman SK, Faulkner JE, Choi SC, Selhorst JB, Harrison JW, Lutz HA, Young HF, Becker DP. Further experience in the management of severe head injury. J Neurosurg. 1981;54:289-299.
  18. Chesnut RM, Marshall SB, Piek J, Blunt BA, Klauber MR, Marshall LF. Early and late systemic hypotension as a frequent and fundamental source of cerebral ischemia following severe brain injury in the Traumatic Coma Data Bank. Acta Neurochir Suppl. 1992;59:121-125.
  19. Chesnut RM. Avoidance of hypotension: conditio sine qua non of successful severe head-injury management. J Trauma. 1997;42:S4-S9.
  20. Jeret JS, Benjamin JL. Risk of hypotension during apnea testing. Arch Neurol. 1994; 51:595-599.
  21. Cingolani HE, Faulkner SL, Mattiazzi AR, Bender HW, Graham TP. Depression of human myocardial contractility with ‘respiratory’ and ‘metabolic’ acidosis. Surgery. 1975; 77:427-432.
  22. Miller JD, Butterworth JF, Gudeman SK, Faulkner JE, Choi SC Selhorst JB, Harrison JW, Lutz HA, Young HF, Becker DP. Further experience in the management of severe head injury. J Neurosurg. 1981;54:289-299.
  23. Miller JD. Physiology of trauma. Clin Neurosurg. 1982;29:103-130.
  24. Lewelt W, Jenkins L, Miller JD. Autoregulation of cerebral blood flow after experimental fluid percussion injury of the brain. J Neurosurg. 1980;53:430-511.
  25. Schafer JA, Caronna JJ. Duration of apnea needed to confirm brain death. Neurology. 1978;28:661-666.
  26. Perel A, Berger M, Cotev S. The use of continuous flow oxygen and PEEP during apnea in the diagnosis of brain death. Arch Neurol. 1991;48:1215-1216.
  27. Benzel EC, Gross CD, Hadden TA, Kesterson L, Landrieau MD. The apnea test for the determination of brain death. Acta Anaesthesiol Belg. 1989;71:191-194.
  28. Allen N, Burkholder JD, Molinari GF, Comiscioni J. Clinical criteria of brain death. In: The NINCDS Collaborative Study of Brain Death. Bethesda, Md: National Institutes of Health; 1980:77-147. NIH publication 81-2286.
  29. Walker AE, Diamond El, Mosely JI. The neuropathological findings in irreversible coma . J Neuropathol Exp Neurol. 1975;34:295-323.
  30. Rowland TW, Donnelly JH, Jackson AH. Apnea documentation for determination of brain death in children. Pediatrics. 1984;74:435-438.
  31. Ebata T, Watanabe Y, Amaha K, Hosaka Y, Tagaki Y. Haemodynamic changes during the apnoea test for diagnosis of brain death. Can. J. Anaesth. 1991; 38:436-440.
  32. Hung T, Chen S-T. Prognosis of deeply comatose patients on ventilators. J Neurol Neurosurg. 1995; 58:75-80.
  33. Ropper AH. Unusual spontaneous movements in brain-dead patients. Neurology. 1984;34:1089-1092.
  34. Green MB, Wikler D. Brain death and personal identity. Philos Public Affairs. 1980;9:105-133.
  35. Lindenberg R. Systemic oxygen deficiency: the respirator brain. In: Minckler J (ed) Pathology of the nervous system. New York, NY: McGraw-Hill, 1971:1583-1617.
  36. Matakas F, Cervos-Navarro J, Schneider H. Experimental brain death. J Neurol Neurosurg Psychiat. 1973;36:497-438.
  37. Schwab S, Spranger M, Aschoff A, Steiner T, Hacke W. Brain temperature monitoring and modulation in patients with severe MCA infarction. Neurology. 1997;48:762-767.
  38. Metz C, Holzschuh M, Bein T, Woertgen C, Frey A, Frey I, Taeger K, Brawanski A. Moderate hypothermia in patients with severe head injury and extracerebral effects. J Neurosurg. 1996;85:533-541.
  39. Coimbra C, Cavalheiro EA. Protective effect of short-term postischemic hypothermia on the gerbil brain. Brazilian J Med Biol Res. 1990;23:605-611.
  40. Coimbra C, Wieloch T. Hypothermia ameliorates neuronal survival when induced 2 hours after ischaemia in the rat. Acta Physiol Scand. 1992;146:543-544.
  41. Caroll M, Beek O. Hypothermic protection against hippocampal CA1 cell loss is dependent on delay of initiation and duration. Metab Brain Dis. 1992;7:45-43.
  42. Coimbra C, Wieloch T. Moderate hypothermia mitigates neuronal damage in the rat brain when initiated several hours following transient cerebral ischemia. Acta Neuropathol (Berlin). 1994;87:325-331.
  43. Coimbra C, Drake M, Boris-Möller F, Wieloch T. Long-lasting neuroprotective effect of postischemic hypothermia and treatment with an anti-inflammatory/antipyretic drug: evidences for chronic encephalopathic processes following ischemia. Stroke. 1996;27:1578-1585.
  44. Clasen R A, Pandolfi S, Laing I, Casey D. Experimental study of relation of fever to cerebral edema. J Neurosurg. 1974; 41:576-581.
  45. Przelomski MM, Roth RM, Gleckman RA, Markus EM. Fever in the wake of a stroke. Neurology. 1986;36:427-429.
  46. Hindfelt B. The prognostic significance of subfebrility and fever in ischaemic cerebral infarction. Acta Neurol Scand. 1976;53:72-79.
  47. Coimbra C, Boris-Möller F, Drake M, Wieloch T. Diminished neuronal damage in the rat brain by late treatment with the antipyretic dipyrone or cooling following cerebral ischemia. Acta Neuropathol (Berlin). 1996;92:447-453.
  48. Ginsberg MD, Pulsinelli W. The ischemic penumbra, injury thresholds and the therapeutic time window for acute stroke. Ann Neurol. 1994;36:553-554.
  49. Jones PA, Andrews PJ, Midgley S, Anderson SI, Piper IR, Tocher JR, Housley AM, Corrie JA, Slattery J, Dearden NM. Measuring the burden of secondary insults in head-injured patients during intensive care. J Neurosurg Anesthesiol. 1994;6:4-14
  50. Hacke W, Zeumer H, Ferbert A, Brückmann H, del Zoppo GJ. Intra-arterial thrombolytic therapy improves outcome in patients with acute vertebrobasilar occlusive disease. Stroke. 1988;19:1216-1222.
  51. Hayashi J, Oguma F, Miyamura H, Eguchi S, Koike T. Direct thrombolytic revascularization of the occluded basilar artery. Cardiovasc Surg. 1993;1:547-549.
  52. Koberda J L, Clark WM, Lutsep H, Nesbit G. Successful Clinical Recovery and Reversal of Mid-Basilar Occlusion in Clinically Brain Dead Patient with Intra-Arterial Urokinase Neurology. 1997; 48 (suppl):A154.
  53. Wijdicks EFM, Scott JP. Outcome in patients with acute basilar artery occlusion requiring mechanical ventilation. Stroke. 1996;27:1301-1303.
  54. Buchan A. Advances in cerebral ischemia: experimental approaches. Neurol. Clin. 1992;10:49-61.
  55. Barone FC, Feuerstein GZ, White RF. Brain Cooling during complete focal ischemia provides complete neuroprotection. Neurosci Biobehav Rev. 1997;21:31-44.
  56. Colbourne F, Sutherland G, Corbett D. Postischemic hypothermia. A critical appraisal with implications for clinical treatment. Mol Neurobiol. 1997;14:171-201.
  57. Giacomini M. A change of heart and a change of mind? Technology and the redefinition of death in 1968. Soc Sci Med. 1997;44:1465-1482.