Brain Death

• Hypoxic brain damage
• Trauma
• Vascular- ischemic / haemorrhagic stroke
• Fulminant systemic/ brain infections
• Inflammatory conditions- vasculitis
• Autoimmune conditions- neurosarcoidosis

Brain death is classified into:

• Whole brain death: Complete loss of function of both the brain and brainstem.
• Brainstem death: Irreversible loss of brainstem function (controls breathing and vital reflexes), which automatically means the rest of the brain cannot function either.

A person who is brain dead will show:

• No breathing without ventilator support.
• No movement of the eyes, even when tested with light or touch.
• No coughing, swallowing, or gag reflex.
• No response to painful or external stimuli.
• No spontaneous body movements.

Brain death is diagnosed with strict clinical tests performed by doctors, including:

• Fixed pupils with no response to light
• Absence of corneal or conjunctival reflex
• No response on caloric testing (no eye movement when cold water is placed in the ear canal)
• Absence of spontaneous breathing
• Absence of gag reflex
• No motor response to painful stimulus
• No respiratory movements on disconnection from ventilator, even after increase in CO2 in blood

• The cause of irreversible brain damage should be confirmed.
• Other curable causes of coma (such as sedative medications, hypothermia, metabolic and endocrine causes) should be excluded.
• The patient should be hemodynamically stable (blood pressure and circulation maintained) on ventilator

There is no treatment or cure for brain death, as the brain damage is irreversible. Medical care may focus on maintaining organ function temporarily with a ventilator and medications.

Brain death is not a condition that develops gradually at home; it occurs as a result of catastrophic brain injury or illness that requires emergency hospital care. Families should consult doctors immediately if a loved one has suffered a major trauma, stroke, or cardiac arrest and is on ventilator support.