Difficulties in assessing brain death in a case of benzodiazepine poisoning with persistent cerebral blood flow

@article{Marrache2004DifficultiesIA,
  title={Difficulties in assessing brain death in a case of benzodiazepine poisoning with persistent cerebral blood flow},
  author={Fr{\'e}d{\'e}ric Marrache and Bruno M{\'e}garbane and S Pirnay and Abdel Rhaoui and Marie Thuong},
  journal={Human and Experimental Toxicology},
  year={2004},
  volume={23},
  pages={503 - 505}
}
Assessing brain death may sometimes be difficult, with isoelectric EEG following psychotrope overdoses or normal cerebral blood flow (CBF) persisting despite brain death in the case of ventricular drainage or craniotomy. A 42-year-old man, resuscitated after cardiac arrest following a suicidal ingestion of ethanol, bromazepam and zopiclone, was admitted in deep coma. On day 4, his brainstem reflexes and EEG activity disappeared. On day 5, his serum bromazepam concentration was 817 ng/ml… 

Diagnosis of brain death

The methodology of diagnosing death, based on finding any of the signs of death, is reviewed, which shows that the irreversible loss of cardio-circulatory and respiratory functions can cause death only when ischemia and anoxia are prolonged enough to produce an irreversible destruction of the brain.

A Review of Ancillary Tests in Evaluating Brain Death

  • M. HeranN. HeranS. Shemie
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    Canadian Journal of Neurological Sciences / Journal Canadien des Sciences Neurologiques
  • 2008
The history of diagnosis ofbrain death, pathophysiologic issues in making this determination, and currently available CBF imaging techniques are reviewed, discussing each in turn with respect to their utility in the diagnosis of brain death.

Alprazolam and lorazepam overdose and the absence of brainstem reflexes

A 70-year-old unresponsive woman was hypothermic and had rapid shallow breathing, with pinpoint pupils and absent corneal, oculocephalic and oculovestibular reflexes, and the cause of her unconsciousness was uncovered when her husband found empty bags of alprazolam and lorazepam.

Transcranial Doppler ultrasonography to confirm brain death: a meta-analysis

CCA by TCD in the anterior and posterior circulation predicted fatal brain damage in all patients; therefore, TCD can be used to determine the appropriate moment for angiography.

Limitations of computed tomographic angiography in the diagnosis of brain death

In clinically BD patients with no electroencephalographic activity CT-a documents opacification of the intracerebral vessels in a significant percentage of the cases and cannot be recommended as a means of BD diagnosis.

Brain death diagnosis

Brain death (BD) diagnosis should be established based on the following set of principles, i.e. excluding major confusing factors, identifying the cause of coma, determining irreversibility, and

The evolution of brain death.

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Every step in the determination of brainDeath bears potential pitfalls which can lead to errors in the diagnosis of brain death, and possible solutions are identified.

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CTA had a high diagnostic accuracy and reproducibility to confirm brain death in patients with an intact skull and the modified Frampas criteria increased the sensitivity of CTA, particularly in Patients with a skull defect.

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