title: Influence of antemortem medication on the determination of brain death.
abstract: Post-mortem concentration of pentobarbital in the blood and brain of two deceased neurosurgical patients was determined by gas chromatography/mass spectrometry. Patients treated with barbiturate for elevated intracranial pressure after head injury may incur brain death. In the present two cases of brain death a large amount of barbiturate remained in the brain, even when the blood concentration was not detectable, possibly because the blood flow was stagnant in the brain. It is suggested that a patient under barbiturate coma should be given serious consideration as to the determination of brain death, even if barbiturate is negative in the blood.
authors.affiliation: Department of Forensic Medicine, Tokai University School of Medicine, Isehara, Japan.
authors.forename: T
authors.initials: T
authors.lastname: Saito
authors.forename: S
authors.initials: S
authors.lastname: Takeichi
authors.forename: Y
authors.initials: Y
authors.lastname: Nakajima
authors.forename: N
authors.initials: N
authors.lastname: Yukawa
authors.forename: M
authors.initials: M
authors.lastname: Osawa
mesh_terms: D000293:Adolescent; D001921:Brain / Q000378:metabolism*; D001926:Brain Death / Q000175:diagnosis*; D002675:Child, Preschool; D003128:Coma / Q000175:diagnosis / Q000209:etiology; D006259:Craniocerebral Trauma / Q000188:drug therapy*; D003937:Diagnosis, Differential; D005260:Female; D008401:Gas Chromatography-Mass Spectrometry; D006801:Humans; D008297:Male; D010424:Pentobarbital / Q000493:pharmacokinetics* / Q000627:therapeutic use; D011180:Postmortem Changes
chemical_list: D010424:Pentobarbital