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Question:
What is brainstem death?
Answer:
Brainstem death is defined as the
irreversible loss of all
functions of the brain.
It can be determined in several ways. First, no
electrical activity in the brain; this is determined by
an EEG. Second, no blood flow to the brain; this is
determined by blood flow studies. Third, absence of
function of all parts of the brain-as determined by
clinical assessment ( no movement, no response to
stimulation, no breathing, no brain reflexes).
There are several ways in which a person can become
brainstem dead, these include:-
1. Anoxia -
caused
by drowning, respiratory diseases, or drug overdose.
2. Ischemia
- Blockage of an artery leading to the brain or in the
brain, heart attack (stoppage
of the heart for a period of time), bleeding in the
brain.
3. Intracranial hematoma
- caused by a head injury (a blow to the head) or a ruptured
aneurism.
4. A gunshot wound to the head -
causes destruction
of
brain tissue
and swelling of the brain.
5. Intracranial Aneurism
- the
ballooning of a blood vessel supplying the brain-can cut
off
blood
supply or rupture.
6. Brain
tumours
-
can destroy brain tissue and increase pressure within
the brain.
When
any of the above occur, they cause swelling of the
brain. Because the brain is enclosed in the skull, it
does not have room to swell, thus pressure within the
skull increases (this is "intracranial pressure"). This
can stop blood flow to the brain, killing brain cells
and causes herniation of the brain (pushing the brain
outside of its normal space). When brain cells die, they
do not grow back, thus any damage caused is permanent
and irreversable.
Some points to note:
.
A persons' heart can still be beating because of the
ventilator and medications helping to keep the blood
pressure normal.
.
A person who is declared brainstem dead is legally dead.
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