The Neurology of Death and the Dying Brain: A Pictorial Essay

  title={The Neurology of Death and the Dying Brain: A Pictorial Essay},
  author={Daniel Kondziella},
  journal={Frontiers in Neurology},
  • D. Kondziella
  • Published 21 July 2020
  • Psychology, Biology
  • Frontiers in Neurology
As neurologists earn their living with the preservation and restoration of brain function, they are also well-positioned to address the science behind the transition from life to death. This essay in pictures highlights areas of neurological expertise needed for brain death determination; shows pitfalls to avoid during the clinical examination and interpretation of confirmatory laboratory tests in brain death protocols; illustrates the great variability of brain death legislations around the… 
Near-Death Experiences (NDEs) in the Context of Contemporary Science and Historical Speculation and Doctrine
In medicine, life-saving procedures have advanced, resulting in more critical-condition patients being revived from a near-death state—spawning research interest in the near-death experience (NDE).
The evolutionary origin of near-death experiences: a systematic investigation
It is proposed that the acquisition of language enabled humans to transform these events from relatively stereotyped death-feigning under predatory attacks into the rich perceptions that form near-death experiences and extend to non-predatory situations.
Eye-opening in brain death: A case report and review of the literature
Donation after circulatory death: opportunities on the horizon
This review summarizes recent protocols, procedures, and ethics surrounding the increased utilization of donors after circulatory death for transplantation and finds that outcomes are improving, and protocols continue to evolve.


Determining Brain Death
The clinical diagnosis of brain death in a patient with a catastrophic brain injury is determined by a comprehensive clinical examination that involves at least 25 individual assessments and requires excluding confounding factors first, examining the patient carefully with special attention to signs of brainstem function, and, finally, performing an apnea test.
Variability of Brain Death Policies in the United States.
Hospital policies in the United States for the determination of brain death are still widely variable and not fully congruent with contemporary practice parameters, and hospitals should be encouraged to implement the 2010 AAN guidelines.
Brain death declaration
Substantial differences in perceptions and practices of brain death exist worldwide and the identification of discrepancies, improvement of gaps in medical education, and formalization of protocols in lower-income countries provide first pragmatic steps to reconciling these variations.
Confirmation of brainstem death
This review summarises the key components of brainstem testing and provides practical advice when dealing with patients with coma, primarily focuses on clinical practice in the UK but includes a comparison with other countries in Europe and the rest of the world.
Neurochemical models of near-death experiences: A large-scale study based on the semantic similarity of written reports
Predicting the outcome of a comatose patient at the bedside
This review provides a practical approach to evaluating outcome of a comatose patient and suggests that prior comorbidity and permanent organ dysfunction are critical factors in making decisions about de-escalation or escalation of care.
The respirator brain death syndrome.
False memory susceptibility in coma survivors with and without a near-death experience
Examination of NDEs’ susceptibility to false memories using the Deese–Roediger–McDermott (DRM) paradigm demonstrated that NDErs and volunteers were equally likely to produce false memories, but that Nders recalled them more frequently associated with compelling illusory recollection.
Shining a Light on Awareness: A Review of Functional Near-Infrared Spectroscopy for Prolonged Disorders of Consciousness
A burgeoning technique of non-invasive optical neuroimaging—functional near-infrared spectroscopy (fNIRS)—is described and its potential to address the clinical challenges of prolonged disorders of consciousness is reviewed.