[Clinical diagnosis of 26 cases of brain death].
OBJECTIVE
To explore clinical diagnostic criterion of brain death.


METHODS
Evaluation was made on 26 cases of brain death through routine check-up such as brain stem reflex, GCS, pupil dilatation and limbs reflex. Among whom apnea test was made in 10 cases and EEG-Holter monitoring in 5 cases. Different dose of 1 mg, 2 mg, 5 mg Atropine test in 21 cases of brain death were administered to compare with the result in another 15 cases of deep coma patients.


RESULTS
The positive of apnea test has some relation with the mode of respirator executed. The negative of Atropine test in brain death group has significant difference with that of deep coma group (P < 0.05). EEG-Holter is valuable in determining the exact time of brain death. Pupil changes including mydriasis 14 cases, miosis 2 cases and inequality of pupil 5 cases. Limbs reflex was preserved in 5 cases.


CONCLUSIONS
A protocol for executing apnea is recommended. Atropine 1 mg should be the first dosage when executing Atropine test. Dynamic EEG has forensic value while mydriasis and loss of limbs reflex should not be regarded as characteristic sign of brain death.
Zhang
Tian-xi
TX
Department of Neurosurgery, Ruijin Hospital, Shanghai Second Medical University, Shanghai 200050, China.
Shi
Yi-jue
YJ
Sheng
Hui-qiu
HQ
Wei
Guo-hua
GH
Zhao
Wei-guo
WG
D000328:Adult; D000368:Aged; D001285:Atropine; D001926:Brain Death / Q000175:diagnosis*; D004569:Electroencephalography; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011680:Pupil / Q000502:physiology; D012119:Respiration
D001285:Atropine