Brain death: a clinical overview

Since 1950s the concept of brain death has been refined and accepted by the scientific community and the public. Declaration of brain death is an important and separate medical diagnosis that include many steps during the examination. A study by Spears et al provides a detailed overview on the main aspects. A clinical evaluation has to include: assessment of coma, cranial nerves, motor testing, and apnea testing. An observation period should be utilized to prove that the brain injury is irreversible. Generally, at least a 24-h waiting period is recommended as there may be delayed recovery of brainstem function. It is also important to remember that certain medications can lead to comatose states or brainstem areflexia.