Sunday, May 8, 2022

What Happens When You Are Brain Dead

Don't Miss

When Is There A Coronial Investigation

Miraculous recovery for 13-year-old declared brain dead

Every death that happens in an Intensive Care Unit in NSW is assessed to determine if a coronial investigation is required. A death must be referred to the NSW Coroner as a matter of law if:

  • the person died a violent and unnatural death
  • the person died a sudden death and the cause is unknown
  • the person had not been under the care of a doctor within the past six months
  • the person died unexpectedly after having a health-related procedure
  • the person was under a custodial order or under State care at the time of death
  • the doctor was unable to complete the death certificate because of unknown factors leading to the death.

Note: if the person who died wished to be an organ and tissue donor or the next of kin has agreed to donation, permission is sought from the Coroner and the forensic pathologist. If the next of kin do not wish the person who has died to become an organ and tissue donor, the Coroner and the forensic pathologist can not override their wishes.

What Happens To An Individual While These Tests Are Being Done

The individual is placed on a machine that breathes for him or her, called a ventilator. This machine is needed because the brain can no longer send signals telling the body to breathe. Special medications to help maintain blood pressure and other body functions may also be given. During the brain death testing, the ventilator and medications continue but they do not affect the results of the testing.

Identifying Organismal Integration In Tk

I propose that there are at least three bodily functions described in TK’s autopsy report that demonstrate that he is still an integrated whole: blood pressure homeostasis, a robust immune response, and proportionate growth. Significantly, both defenders and critics of the neurological criteria for death agree that the first two functions are indicative of organismal integration. Tonti-Filippini, a defender of the TBD criterion for death, argues that integration is mediated in the human body by the hormonal, i.e., endocrine, system:

The transfer of information merely between one part of the body and another is insufficient to establish that the soul has not separated from the body. For instance, circulation in itself is not a transfer of information that integrates the body. Rather it is a means by which information might be transferred such as happens through the endocrine system.

In brief, my argument is the following: If TK had retained his integration after total brain failure, then we would expect that his three organismal functions would be comparable pre- and post-brain death. In contrast, if TK had lost his integration, then we would expect that his three organismal functions, after the tragic destruction of his brain, would be defective or unreliable or faulty in some way.

Don’t Miss: How To Pass Level 56 On Brain Test

How Is Brain Death Related To Organ Donation

In order to be medically able to become an organ donor, an individual must pass away on a ventilator in a hospital. While being brain dead is not the only way this can happen, it is the most frequent condition of those who become organ donors.

Only after someone has been declared brain dead, legally dead, the hospital will contact the local organ procurement organization to begin the consideration of donation. Not until this point is it looked up to see if someone is registered as a donor and/or the family is approached to be asked if they would like their loved one to be a donor.

Once a legal record of donor registration is found and/or a family has consent then the organ donation process will begin. If someone is not a registered donor and the family does not consent the person will not become a donor.

Here’s What Happens To Your Brain When You Die

What happens when you die: The process your brain goes ...

You might picture yourself walking through a field, or surrounded by loved ones. Or perhaps making your way down a long, dark tunnel, towards a brilliant, beckoning light.

When the end comes, what you experience will be a veiled secret known only to you but whatever it is, scientists say those closing moments of consciousness could be powered by something amazing and mysterious taking place inside your brain.

In 2013, researchers at the University of Michigan found that after clinical death occurred in rats, their brain activity actually flared, revealing electrical signatures of consciousness that exceeded levels found in the animals’ waking state.

“We reasoned that if near-death experience stems from brain activity, neural correlates of consciousness should be identifiable in humans or animals even after the cessation of cerebral blood flow,” said one of the team, neurologist Jimo Borjigin.

And that’s exactly what they detected, with anaesthetised rats displaying a surge of highly synchronised brain activity within 30 seconds of an induced cardiac arrest, consistent with patterns you’d see in a highly aroused brain.

The phenomenon detected was a revelation, to the extent it may disprove the notion that just because blood flow has ceased as a result of clinical death, the brain must necessarily be rendered simultaneously inert.

“It also provides the first scientific framework for the near-death experiences reported by many cardiac arrest survivors.”

Read Also: Bleed In The Brain Stem

Brain Death And Organ Donation

In some cases, a person who is brain dead may be a candidate for organ donation. If the person was a registered organ donor, or if their family knew of their wish to be an organ donor, their death is declared, but the ventilator is left on. Drugs that help preserve the internal organs are still given. The dead person then undergoes an operation to remove viable organs such as kidneys. After the operation is complete, the ventilator is switched off. Funeral arrangements can then be made by the family.

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.

You May Like: Anesthesia Effects On Alzheimer Patients

Other Brain Death Testing

After completing the physical assessment, the physician may elect to order additional testing. While it is typical for both a physical assessment and an apnea test to be done, some people who are not brain dead cannot tolerate apnea testing. Often, in those cases, a flow study will be done. These studies are done to see if blood is traveling to the brain through the bloodstream. If the study shows that no blood is reaching the brain, the test is consistent with brain death.

Some physicians will use an EEG, or electroencephalogram, which is a test that measures brain waves. A person who is brain dead will have a “flat” EEG, as brain waves will be absent.

Atropine, a prescription medication that causes the heart rate to increase, an also be administered as an ancillary test for brain death because it is not effective in brain dead individuals. If the heart rate increases notably after the medication is given, this suggests that a person is not brain dead.

How Can Doctors Tell If Someone Is Brain Dead

Is A Brain Dead Person Actually 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:

You May Like: Does Mike Tyson Have Brain Damage

What Happens In The Brain At The Moment Of Death

In one of the more remarkable neuroscience articles published recently, Dr Ajmal Zemmar of the University of Louisville reported the results of an electroencephalography study of brain wave activity in a patient who died of an unexpected heart attack in the middle of the study.

The EEG study was performed to help diagnose and guide treatment of a patient suffering from seizures. In the patient’s dying moments, Dr. Zemmar and colleagues observed changes in a specific band of neural oscillations, so-called gamma oscillations, but also in others such as delta, theta, alpha, and beta oscillations associated with memory retrieval.

Dr. Zemmar speculated, Through generating oscillations involved in memory retrieval, the brain may be playing a last recall of important life events just before we die, similar to the ones reported in near-death experiences.

It’s hard to know how far to generalize this single patient observation to human brain function as a whole. This patient had suffered head trauma and was experiencing seizures, so the recordings might not necessarily be typical of a normal brain undergoing death.

EEG equipment measuring brainwaves.

getty

But Zemmar and colleagues note that similar brain activity patterns have been noted in laboratory animal studies at time of death.

Does Your Brain Know When Youre Dead

Nov. 8, 2017 — When you die, your brain may know it.

Researchers say that after your heart stops, your brain stops working as well. If your brain has shut down, how is that possible?

But many people who have been resuscitated and, essentially, brought back to life — describe experiences that occurred after death. If your brain is dead, how is that possible?

âSince the 1960s, when CPR was developed and we began to be able to resuscitate people whose hearts had stopped, many of them have reported these unusual experiences in which they had full awareness, consciousness, of events going on at the time of their cardiac arrest,â says Sam Parnia, MD, PhD, director of critical care and resuscitation research at NYU Langone Health in New York City. âIn many cases, those have been verified by medical and nursing staff.â

Each year, as many as 1 out of 5 people whose hearts stop will be revived. The stories that some of them share are often called near-death experiences, or NDEs. These incidents often feature tunnels leading to a bright light, spiritual encounters, meetings with deceased loved ones, and other things that seem mystical. In some cases, people whose hearts have stopped beating describe out-of-body experiences, in which they feel like theyâve left their bodies and seen the efforts to revive them.

âIn the context of cardiac arrest, they are not near death,â says Parnia. âThey really have gone biologically beyond death.â

Don’t Miss: Brainstem Hemorrhage

What Happens When Theres No Brain Activity

When someone is brain dead, it means that the brain is no longer working in any capacity and never will again. Other organs, such as the heart, kidneys or liver, can still work for a short time if the breathing machine is left in place, but when brain death is declared, it means the person has died.

Brain Death Is Different From Vegetative State

What happens when you die: The process your brain goes ...

The difference between brain death and a vegetative state, which can happen after extensive brain damage, is that it’s possible to recover from a vegetative state, but brain death is permanent.

Someone in a vegetative state still has a functioning brain stem, which means:

  • some form of consciousness may exist
  • breathing unaided is usually possible
  • there’s a slim chance of recovery because the brain stem’s core functions may be unaffected

Someone in a vegetative state can show signs of being awake. For example, they may open their eyes but not respond to their surroundings.

In rare cases, a person in a vegetative state may show some sense of response that can be detected using a brain scan, but not be able to interact with their surroundings.

Also Check: Basal Ganglia Bleed

Brain Death Is Not The Same As Coma

Brain death differs from other states of unconsciousness in important ways. For example, coma is similar to deep sleep, except that no amount of external stimuli can prompt the brain to become awake and alert. However, the person is alive and recovery is possible. Brain death is often confused with a persistent vegetative state, but these conditions are not the same either. A persistent vegetative state means the person has lost higher brain functions, but their undamaged brain stem still allows essential functions like heart rate and respiration to continue. A person in a vegetative state is alive and may recover to some degree, given time. Brain death means the person has died.

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.

Also Check: Are Brain Freezes Bad For You

Legal Perspectives On The Mcmath Controversy

As early as 18 days after the hospital had diagnosed Jahi McMath as dead, the Alameda County Superior Court judge held that the child was in fact dead. After confirmation by an independent physician, Judge Grillo agreed that Jahi’s medical condition met the definition set out by California’s Uniform Determination of Death Act, which states in part n individual who has sustained either irreversible cessation of circulatory and respiratory functions, or irreversible cessation of all functions of the entire brain, including the brain stem, is dead. While California’s statute does not contain a religious exception, the judge in this case provided Jahi’s parents considerable time to pursue opportunities to have her body transferred to another facility. The amount of time is significant given the moral and professional burdens on health care providers to support a body that has been declared dead.

As discussed above, Judge Grillo entered a TRO requiring that the hospital continue ventilator support until Jahi’s parents were given time to explore options for transfer. Because TROs significantly deprive the opposing party of freedom, they are reserved for situations in which the filing party is facing irreparable harm, no other legal form of remedy is available, and a substantial likelihood of success of winning a case on the merits exists. The court must balance the potential hardship to the opposing party as well as any impact on the public following their decision.

What Happens After Brain Death Is Confirmed

Brain dead: What it is, what it isn’t

Once someone has been confirmed as brain dead, and before anything else is done, the ICU doctor will meet with their immediate family to explain the situation and decide when the ventilator should be switched off and the heart allowed to stop.

If the person who has died is able to donate their organs and tissue, the doctor will discuss with the family the possibility of donation. If the family agrees to donation, the patient will be kept in the ICU connected to the ventilator receiving care for another 12 – 24 hours. If the family decides to stop the ventilator, and/or decides not to donate their loved ones organs and tissue, the ICU staff will help guide them through this process.

Every attempt will be made to cater to the wishes of each individual family, keeping in mind that once someone is brain dead, their heart may stop even before the ventilator is turned off.

Social workers, pastoral care workers and ministers of religion are available to help the family during this difficult time.

Recommended Reading: Medical Term For Bleeding In The Brain

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.

More articles

Popular Articles