Death by neurologic criteria: pathophysiology, definition, diagnostic criteria and tests

Minerva Anestesiol. 2019 Jul;85(7):774-781. doi: 10.23736/S0375-9393.19.13338-X. Epub 2019 Mar 12.

Abstract

Death by neurologic criteria is an irreversible sequence of events culminating in permanent cessation of cerebral functions. In this context, there are no responses arising from the brain, no cranial nerve reflexes nor motor responses to pain stimuli, and no respiratory drive. The diagnosis of death by neurologic criteria implies that there is clinical evidence of the complete and irreversible cessation of brainstem and cerebral functions. The diagnosis, confirmation, and certification of death are core skills for medical practitioners. The aim of this review is to discuss the pathophysiology and definition of death by neurological criteria, describing the clinical assessment, and the use of ancillary tests for the diagnosis of brainstem death.

Publication types

  • Review

MeSH terms

  • Apnea / etiology
  • Brain / physiopathology
  • Brain Death / diagnosis*
  • Brain Death / physiopathology
  • Brain Injuries / physiopathology
  • Brain Stem / physiopathology
  • Coma / diagnosis
  • Death*
  • Diabetes Insipidus / etiology
  • Diabetes Insipidus / physiopathology
  • Diagnosis, Differential
  • Disease Progression
  • Electrodiagnosis
  • Heart Arrest / etiology
  • Hemodynamics
  • Hypothalamo-Hypophyseal System / physiopathology
  • Neuroimaging
  • Neurologic Examination
  • Reflex, Abnormal
  • Reflex, Pupillary / physiology
  • Sympathetic Nervous System / physiopathology