Electrocerebral silence with preserved but reduced cortical brain perfusion.
Isoelectric electroencephalogram in conformance with clinical findings is strongly suggestive of brain death. In clinical practice, isoelectric electroencephalogram in not-brain-dead patients is rarely seen. We report on a 53-year-old patient who suffered ischaemic encephalopathy after cardiopulmonary arrest. He had residual brainstem function with sufficient spontaneous breathing and evidence of cerebral blood flow on single photon emission computed tomography scan, but his electroencephalogram was isoelectric. He survived this condition for more than 7 weeks. This case demonstrates that isoelectric electroencephalogram can not be equated with brain death, and that in prognostic assessment both clinical findings and supportive technical methods are mandatory.
Heckmann
Josef G
JG
Department of Neurology, University of Erlangen-Nuremberg, Schwabachanlage 6, 91054 Erlangen, Germany. josef.heckmann@neuro.imed.uni-erlangen.de
Lang
Christoph J G
CJ
Pfau
Matthias
M
Neundörfer
Bernhard
B
D001921:Brain / Q000098:blood supply*; D001926:Brain Death / Q000175:diagnosis*; D001929:Brain Edema / Q000000981:diagnostic imaging / Q000209:etiology; D016887:Cardiopulmonary Resuscitation; D002560:Cerebrovascular Circulation; D003072:Cognition Disorders / Q000175:diagnosis / Q000209:etiology / Q000628:therapy; D004569:Electroencephalography; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000150:complications / Q000175:diagnosis* / Q000628:therapy*; D014057:Tomography, X-Ray Computed