Brain Death

A severe stroke can improve. In fact, over 80% of stroke victims survive, and many go on to live productive, fulfilling lives. But, sometimes after a stroke, the stroke victim’s family's worst fears can come true. That is when your loved one does not survive, dying within a few days of having a stroke.

Often, death from a stroke is not as obvious as you might think. In some situations, your loved ones will be declared brain dead while in the hospital.

What is brain death?

Brain death is a situation in which the brain has undergone such severe irreversible damage that there is no viable brain or possibility that the person will ever recover. This means that a person cannot think, cannot have purposeful movement, cannot feel anything and cannot hear. People who are brain dead are unable to eat or have bowel or bladder control.

A doctor carefully examines neurological functions and reflexes to determine if any brain activity is still operational before declaring a person brain dead. The medical team must also confirm that the damage is irreparable before declaring someone brain dead.

When is someone declared brain dead?

Brain death is when a person no longer has brain function. Doctors perform a detailed neurological examination to confirm that there is no brain function before declaring a person brain dead.

Because some medications that are used in the intensive care setting can interfere with brain activity, patients need to have a neurological test for brain function while off of the medication.

A person can continue to have a heartbeat and breathing coordinated by a life-sustaining machine even while he is brain dead.

Is brain death actual death?

Yes, brain death is actual death. The reason that the term 'brain dead' is used is because some patients who are extremely sick are able to maintain 'life' through machines.

Determination of brain death means that if the machines are removed, the patient cannot resume life ever again, even if given the most heroic medical treatment available.

Do doctors lie about brain death to get organ donations?

There is no incentive for doctors to lie about brain death in order to obtain organs for transplant patients or for research. The doctors who care for critically ill patients are not the same doctors who transplant organs into other patients. In fact, because of organ transplant criteria, a number of organ transplants have a transplant recipient who is located in a state or city other than that of the donor.

Some patients who have certain infections or diseases that can be transmitted to recipients are not allowed to be organ donors.

Do doctors make mistakes about brain death?

Errors in declaring a person brain dead are the source of science fiction tales, but are extremely rare in real life, primarily because there are so many providers who must agree on the diagnosis of brain death using criteria obtained through repeated physical examinations at different times.

Sometimes, medical teams use diagnostic testing such as electroencephalogram (EEG) to see if there is any viable brain activity to confirm brain death.

What should I do if my loved one is declared brain dead?

If your loved one is declared brain dead, this means that there are no known options that can save her life. If you are in disbelief about the situation, you can obtain another opinion from a different physician.

Your loved one has probably designated someone to make medical decisions on her behalf in a crisis, and if you are that designated person, you are entitled to see the medical chart, to ask questions and to get explanations from her health care providers.

If you are the designated decision maker, you might find yourself explaining the situation to the rest of your family. Of course, you can ask the professional staff to help you explain the facts and answer questions about your loved one's death. It is never an easy situation, but rest assured that if you have been told that your loved one is brain dead, there is nothing you could have done and no reason to feel that you should have done anything differently.


Controversies of diffusion weighted imaging in the diagnosis of brain death, Luchtmann M. Bernarding J. Beuing O.  Kohl J. Bondar I. Skalej M. Firsching R, Journal of Neuroimaging, October 2013

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