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Can You Recover From Brain Death

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How Long Can The Brain Go Without Oxygen A Timeline

Is A Brain Dead Person Actually Dead?
  • Between 30-180 secondsof oxygen deprivation, you may lose consciousness.
  • At the one-minute mark, brain cells begin dying.
  • At three minutes, neurons suffer more extensive damage, and lasting brain damage becomes more likely.
  • At five minutes, death becomes imminent.
  • At 10 minutes, even if the brain remains alive, a coma and lasting brain damage are almost inevitable.
  • At 15 minutes, survival becomes nearly impossible.

There are, of course, exceptions to every rule. Some training routines help the body make more efficient use of oxygen, enabling the brain to go longer periods without this vital element. Free divers routinely train to go long periods without oxygen, and the current record holder, Aleix Segura held his breath for 24 minutes and 3 seconds without sustaining brain damage!

A Summary Of Tk’s Autopsy Report

At the time of his brain-only autopsy, TK’s body measured approximately 3½ feet long with an approximate weight of 155 pounds. His extremities were symmetric, but poorly developed with muscles of severely reduced mass. His head was disproportionately small for his body size, probably because he did not have a growing brain to keep expanding the skull.

When the skull was opened, the autopsy revealed a hard, nearly spherical mass of approximately four inches in diameter with an irregular surface. No definite posterior brain structures including neither the cerebellum nor the brain stem were identifiable. CT analysis revealed irregular densities and signal changes consistent with calcification throughout the interior of the mass. MRI of the same sample revealed no identifiable specific anatomic brain structures. Sectioning of the mass with a saw revealed that the specimen consisted of a hollow hard-calcified shell containing semisolid material resembling clotted blood surrounding cyst-like spaces. There were no identifiable cerebral structures within the mass. Microscopic examination revealed mineralized deposits and material that resembled blood clots that had become, as the autopsy described it, mummified. No nerve cells or nerve cell structures were recognizable under the light microscope. No signals for any neuronal specific markers were detected by immunohistochemistry.

Establishing The Absence Of Respiratory Function

The final step in establishing brain death is the apnea test. Apnea is the medical term for the suspension of breathing and is used in this instance to ascertain whether the suspension is permanent.

To perform an apnea test, the doctor would take the following steps:

  • The person on a mechanical ventilator would be connected to a pulse oximeter. This is the device used to measure the saturation of oxygen in the blood.
  • The ventilator would then be disconnected and a tube would be inserted into the person’s trachea to deliver 100 percent oxygen to the lungs. This ensures the person is never oxygen-deprived if he or she does respond.
  • Blood tests would immediately be performed to measure baseline blood gases.
  • The doctor would then wait for eight to 10 minutes to see if there is any response from the patient.
  • After eight to 10 minutes, the blood gases would again be tested.
  • If there is no respiratory movement and the PaCO2 has increased to over 60meaning that there has been no exchange of oxygen and carbon dioxide in the lungsthe person will be declared brain-dead.

    If on the other hand, a respiratory movement is observed, then the person cannot be considered brain-dead. Further investigations would then be performed to identify what, if anything, can be done to reverse the condition.

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    Am I Allowed To Stay With My Child While These Tests Are Being Carried Out

    Generally yes. Some parents want to stay with their child while the tests are being carried out, while others prefer to leave.

    Parents who want to stay should talk to the nurse or doctor caring for the child. They will say whether this will be possible, and arrange for someone to stay with the parents during the process to explain fully what is happening.

    What Is Brain Death

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    Brain Death is when an irreversible and complete loss of brain and brain stem function has taken place. This means that there is absolutely no brain activity and brain activity will not return.

    It is considered both a legal and medical definition of death.

    At this point, the patient is incapable of surviving without mechanical support.

    You can see the difference of a brain with blood flow and brain activity, and one that is without any function.

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    Rewiring The Brain’s Reward System

    Methamphetamine addiction also damages the brain’s so-called pleasure center. These regions of the brain include the ventral tegmental area, nucleus accumbens, and frontal lobe. Changes in these brain regions are usually permanent.

    Changes to the brain’s reward center are largely responsible for the drug cravings a person can experience when they quit.

    How Can Doctors Tell If Someone Is Brain Dead

    Doctors first make sure the person doesn’t have a medical problem that causes a deep coma similar to brain death. Such problems include:

    • Overdose of certain kinds of drugs

    If the person doesn’t have one of those problems, doctors do a physical exam to look for signs of brain activity including:

    • Trying to breathe if the ventilator is turned off

    • Flinching or moving if the person is pinched or poked by a needle

    • Gagging on something put in the back of the throat

    • Blinking if something touches an eyeball

    • Pupils narrowing in response to a flashlight

    If there’s no sign of brain activity, doctors sometimes test again 6 to 24 hours later to make sure the person again shows no response. After testing twice with no response, doctors know that the person is brain dead.

    Instead of waiting a day to repeat the examination, doctors may do:

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    What Is Brain Stem Death

    Brain stem death is one of the two ways doctors can certify someone, either an adult or a child, as having died. The other is cardiorespiratory death, and is when breathing and circulation has stopped.

    The brain stem is at the very bottom of the brain and controls many functions vital to life such as consciousness, awareness, breathing and the ability to regulate heart rate and blood pressure.

    The brain stem can stop working for a number of reasons for example, when other areas of the brain are affected by trauma, bleeding, infections or tumours. Regardless of the cause the brain responds to injury by swelling and unlike other areas of the body there is little room for expansion inside the closed skull. Pressure then builds up and causes a decrease in blood flow as well as damage to the tissues.

    This pressure and swelling causes death by a process called coning where the brain is forced through a small opening at the base of the skull where it meets the spinal cord. Medical treatment may help to limit the build up of pressure but it is not always possible to stop or reverse this.

    When the brain stem stops working, the brain cannot send messages to the body to control our unconscious functions, and equally cannot receive messages back from the body. If this is the case, then the person has no chance of recovery, the damage is irreversible and according to UK law, the person has died.

    Survivors Of Brain Death

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    In addition to the above-mentioned dramatic, spontaneous full recovery from brain death, there are also many well-documented cases of brain-death survivors. Though pronounced dead according to the neurological standard, these patients continued to live, albeit in the severe disabling state of chronic brain death. The following is not an unlikely scenario: a severely brain-injured patient was declared brain-dead the family, however, declined organ donation the patient did not die, that is, he or she did not have cardiac arrest, contrary to the insistent claim that imminent asystole necessarily follows brain death. After a few weeks, once the initial hemodynamic instability subsides, gastrointestinal motility returns along with spinal hyperreflexia, and the patient continues to live on for weeks and months without aggressive medical intervention, requiring only a mechanical ventilator, tube feeding, and basic nursing care .

    in a chapter on head injury, multisystem derangements are interpreted as therapeutic challenges to keep a critically injured patient alive, whereas in a typical chapter on BD the same derangements are cited as evidence that the patient has already died.

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    Responding To An Important Objection: The Probative Value Of Tk’s Case

    On February 34, 2005, the Pontifical Academy of Sciences, in cooperation with the World Organization for the Family, hosted a conference at the Vatican to discuss the validity of the brain-related criteria for death. In its final report on the proceedings of the meeting, the Pontifical Academy of Sciences raised an important objection to TK’s case. Basically, its final statement defending the validity of the neurological criteria for death suggests that TK’s case is an outlier, an exception to the rule, that is not relevant to the brain-death debate:

    If was a valid documented case of brain death, it makes the point that in extraordinarily rare exceptions this kind of case occurs. However, many years have passed since this case, there is a great deal of uncertainty about it, and one cannot generalise from it to invalidate the criteria for brain deathThe neurological community does not believe that this case disturbs the conceptual validity of brain death as being equivalent to human death.

    To put it another way, given the exceptionality of TK’s case, the Pontifical Academy is proposing that TK’s autopsy report is not probative for understanding the state of all/most/more than a few patients diagnosed with total brain failure.

    If being alive as a biological organism requires being a whole that is more than the mere sum of its parts, then it would be difficult to deny that the body of a patient with total brain failure can still be alive, at least in some cases.

    How Brain Death Is Diagnosed

    There is more to the loss of consciousness than not being awake. Sleep and coma, for example, each involves the loss of consciousness and are largely defined by the time it takes to return to consciousness. Even a person in a persistent vegetative state has the possibility, albeit slight, of waking up.

    Brain death is different. As the term suggests, brain death indicates that there is no brain activity and, as such, no hope of recovery. Medically speaking, brain death is the definitive diagnosis of death.

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    How Is It Decided That An Individual Is Brain Dead

    A doctor will do tests to make a diagnosis of brain death. These tests are based on sound and legally accepted medical guidelines. Tests include a clinical examination to show that an individual has no brain reflexes and cannot breathe on his or her own. In some situations, other tests may be needed. You can ask your doctor to explain or show you how brain death was determined for your loved one.

    Possibly, an individual may show spinal activity or reflexes such as twitching or muscle contractions. Spinal reflexes are caused by electrical impulses that remain in the spinal column. These reflexes may happen even though the brain is dead.

    Responsibilities Of Physicians Determining Brain Death

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    The diagnosis of brain death is primarily clinical. No other tests are required if the full clinical examination, including each of two assessments of brain stem reflexes and a single apnoea test, is conclusively performed. In the absence of either complete clinical findings consistent with brain death, or confirmatory tests demonstrating brain death, brain death cannot be diagnosed and certified. These guidelines apply to patients one year of age or older.

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    How Does Prompt Care Affect Brain Hemorrhage Recovery Time

    Not all brain bleeds result in death. In fact, death is generally caused by the most extreme cases. Most patients can survive if treatment is sought in due time. How well an affected person responds to brain bleeds is determined by the size of the severity of the bleeding, its location, and the amount of swelling that result from the bleeding. Some patients recover fully after the bleeding if proper treatment is provided, but others survive with various complications.

    Possible complications that the patients could endure include loss of brain function, stroke, and adverse reactions to medications. Sadly, death is also still a possibility even after treatment, but the sooner you seek treatment, your odds greatly improve. Bottom line, if you have any of the symptoms listed earlier in this piece, or if you have recently suffered a traumatic injury to the head, don’t wait. Seek treatment as soon as possible. It could save your life.

    Life After Brain Death: Is The Body Still ‘alive’

    ByRachael Rettner03 January 2014

    A 13-year-old girl in California continues to be on a ventilator after being declared brain-dead by doctors. Although a brain-dead person is not legally alive, how much of the body will keep on working with the help of technology, and for how long?

    Jahi McMath of Oakland, Calif., was declared brain-dead last month after experiencing an extremely rare complication from tonsil surgery. Jahi’s family members have fought to keep their daughter on a ventilator, but a judge has ordered that the machine be turned off next week.

    A person is considered brain-dead when he or she no longer has any neurological activity in the brain or brain stem meaning no electrical impulses are being sent between brain cells. Doctors perform a number of tests to determine whether someone is brain-dead, one of which checks whether the individual can initiate his or her own breath, a very primitive reflex carried out by the brain stem, said Dr. Diana Greene-Chandos, an assistant professor of neurological surgery and neurology at Ohio State University Wexner Medical Center. “It’s the last thing to go,” Greene-Chandos said.

    In the United States and many other countries, a person is legally dead if he or she permanently loses all brain activity or all breathing and circulatory functions. In Jahi’s case, three doctors have concluded that she is brain-dead.

    Greene-Chandos said Jahi’s case is tragic, and as a mother, she is heartbroken for the family.

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    Why Does The Brain Need Oxygen

    The brain represents just 2% of a person’s body weight, yet it uses about 20% of the body’s oxygen supply. Without it, the brain can’t perform even the most basic functions. The brain relies on glucose to power the neurons that control everything from conscious functions like planning and thought to automatic, unconscious processes like managing heart rate and digestion.

    Without oxygen, the brain’s cells cannot metabolize glucose, and therefore cannot convert glucose into energy.

    When your brain is deprived of oxygen, then, the ultimate cause of brain death is inadequate energy to power the brain’s cells.

    Can A Brain Dead Person Open Their Eyes

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    A person who is brain dead is dead, with no chance of revival. Coma: A state of profound unresponsiveness as a result of severe illness or brain injury. Patients in a coma do not open their eyes or speak, and they do not exhibit purposeful behaviors. Some patients need ventilators while others do not

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    Establish Proximate Cause And Irreversibility Of Coma

    A prerequisite to the determination of brain death is the identification of the proximate cause and irreversibility of coma. Severe head injury, intracerebral hemorrhage, aneurysmal subarachnoid hemorrhage, hypoxic-ischemic brain insults and fulminant hepatic failure are potential causes of irreversible loss of brain function. The physician should assess the extent and potential reversibility of any damage, and also exclude confounding factors such as drug intoxication, neuromuscular blockade, hypothermia, or metabolic abnormalities that cause coma but are potentially reversible.

    Establishing the cause and irreversibility of coma requires the physician to wait an appropriate period of time sufficiently long as is relevant for the individual patient in order to rule out any confounding factors and the possibility of recovery. The evaluation of a potentially irreversible coma should also include, as may be appropriate to the particular case:

    • Clinical or neuro-imaging evidence of an acute CNS catastrophe that is compatible with the clinical diagnosis
    • Exclusion of complicating medical conditions that may confound clinical assessment
    • Exclusion of significant hypothermia or hypotension
    • Normal core temperature should be:
    • > 36°C
    • Consider age specific norms
    • See Appendix 1
  • Normal systolic blood pressure should be:
  • 100 mm Hg
  • Consider age specific norms
  • See Appendix 1
  • Most Common Signs Of Oxygen Deprivation

    Most cases of oxygen deprivation have an immediate, obvious cause. A person is at risk of oxygen deprivation under a number of circumstances, including:

    • Strangulation, which blocks blood flow to the brain, thereby preventing oxygen from getting to the brain’s cells.
    • Cardiac or respiratory arrest due to accidents, heart attacks, strokes, and similar catastrophic events.
    • Choking.
    • Brian tumors that impede blood flow.
    • Heart arrhythmias.
    • Smoke or carbon monoxide inhalation.
    • Extremely low blood pressure, which is common when the body goes into shock due to other injuries.
    • Poisoning, including via overdose of prescription and illicit drugs or alcohol.
    • Broken or compressed trachea.

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    How Brain Death Occurs

    Brain death can occur when the blood and/or oxygen supply to the brain is stopped. This can be caused by:

    • cardiac arrest when the heart stops beating and the brain is starved of oxygen
    • heart attack a serious medical emergency that occurs when the blood supply to the heart is suddenly blocked
    • stroke a serious medical emergency that occurs when the blood supply to the brain is blocked or interrupted
    • blood clot a blockage in a blood vessel that disturbs or blocks the flow of blood around your body

    Brain death can also occur as a result of:

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