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49-551: (Redirected from Braindead ) [REDACTED] Look up brain-dead in Wiktionary, the free dictionary. Brain Dead , brain dead or brain-dead may refer to: Medicine [ edit ] Brain death , the irreversible cessation of all brain activity Cinema and television [ edit ] Brain Dead (1990 film) , an American horror thriller Braindead (film) ,

98-602: A presidential commission issued a landmark report entitled Defining Death: Medical, Legal, and Ethical Issues in the Determination of Death , which rejected the "higher-brain" approach to death in favor of a "whole-brain" definition. This report formed the basis for the Uniform Determination of Death Act , since enacted in 39 states. Today, both the legal and medical communities in the US use "brain death" as

147-421: A 1992 New Zealand comedy horror film Brain Dead (2007 film) , a horror film BrainDead , an American television series (2016) Music [ edit ] Brain Dead (band) "Braindead", a song by The Vines on the album Melodia "Braindead", a song by Dune Rats on the album The Kids Will Know It's Bullshit "Brain Dead", a song by Judas Priest on the album Jugulator "Brain Dead",

196-470: A large white matter tract, the arcuate fasciculus . Damage to the Broca's area results in expressive aphasia (non-fluent aphasia) while damage to Wernicke's area results in receptive aphasia (also called fluent aphasia). Explicit or declarative (factual) memory formation is attributed to the hippocampus and associated regions of the medial temporal lobe . This association was originally described after

245-553: A legal definition of death, allowing a person to be declared legally dead even if life support equipment maintains the body's metabolic processes . In the UK, the Royal College of Physicians reported in 1995, abandoning the 1979 claim that the tests published in 1976 sufficed for the diagnosis of brain death, and suggesting a new definition of death based on the irreversible loss of brain-stem function alone. This new definition,

294-438: A patient known as HM had both his left and right hippocampus surgically removed to treat chronic [temporal lobe epilepsy]. After surgery, HM had anterograde amnesia , or the inability to form new memories. Implicit or procedural memory , such as complex motor behaviors, involves the basal ganglia. Short-term or working memory involves association areas of the cortex, especially the dorsolateral prefrontal cortex , as well as

343-530: A song by Sharon Needles on the album Battle Axe "Brain Dead", a song by Exodus on the album Pleasures of the Flesh "Brain Dead", a song by Flotsam and Jetsam on the album Unnatural Selection See also [ edit ] Brain Dead 13 , a video game Topics referred to by the same term [REDACTED] This disambiguation page lists articles associated with the title Brain Dead . If an internal link led you here, you may wish to change

392-453: Is accepted that if the cause of the dysfunction is a clear physical trauma there is no need to wait that long to establish irreversibility). The patient should have a normal temperature and be free of drugs that can suppress brain activity if the diagnosis is to be made on EEG criteria. Also, a radionuclide cerebral blood flow scan that shows complete absence of intracranial blood flow must be considered with other exams – temporary swelling of

441-463: Is also the only sense that is represented by the ipsilateral side of the brain. Damage to the olfactory bulb results in a loss of olfaction (the sense of smell). Speech and language are mainly attributed to parts of the cerebral cortex. Motor portions of language are attributed to Broca's area within the frontal lobe. Speech comprehension is attributed to Wernicke's area , at the temporal-parietal lobe junction. These two regions are interconnected by

490-567: Is considered the most sensitive confirmatory test in the determination of brain death. While the diagnosis of brain death has become accepted as a basis for the certification of death for legal purposes, it is a very different state from biological death – the state universally recognized and understood as death. The continuing function of vital organs in the bodies of those diagnosed brain-dead, if mechanical ventilation and other life-support measures are continued, provides optimal opportunities for their transplantation. When mechanical ventilation

539-800: Is considered to have confirmatory value. In the UK it is not considered to be of value because any continuing activity it might reveal in parts of the brain above the brain stem is held to be irrelevant to the diagnosis of death on the Code of Practice criteria. The diagnosis of brain death is often required to be highly rigorous, in order to be certain that the condition is irreversible. Legal criteria vary, but in general require neurological examinations by two independent physicians. The exams must show complete and irreversible absence of brain function (brain stem function in UK), and may include two isoelectric (flat-line) EEGs 24 hours apart (less in other countries where it

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588-421: Is kept on ventilator support until the organs have been surgically removed. If the patient has indicated in an advance health care directive that they do not wish to receive mechanical ventilation or has specified a do-not-resuscitate (DNR) order and the patient has also indicated that they wish to donate their organs, some vital organs such as the heart and lungs may not be able to be recovered. Brain death

637-423: Is much larger than in amphibians and its growth has pushed the basal nuclei into the central regions of the cerebrum. As in the lower vertebrates, the grey matter is generally located beneath the white matter , but in some reptiles, it spreads out to the surface to form a primitive cortex, especially in the anterior part of the brain. In mammals , this development proceeds further, so that the cortex covers almost

686-552: Is responsible for 2% of all adult and 5% of pediatric in-hospital deaths in the United States. In a nationwide survey of pediatric intensive care units (PICU) in the United States in 2019; there were more than 3,000 pediatric brain deaths out of a total of more than 15,344 children who died in PICUs. According to a national study, "brain death evaluations are performed infrequently, even in large PICUs." Cerebrum With

735-426: Is unresponsive coma, the absence of brain-stem reflexes and the absence of respiratory centre function, in the clinical setting in which these findings are irreversible. In particular, there must be definite clinical or neuro-imaging evidence of acute brain pathology (e.g. traumatic brain injury, intracranial haemorrhage, hypoxic encephalopathy) consistent with the irreversible loss of neurological function." In Brazil,

784-527: Is used to support the body of a brain-dead organ donor pending a transplant into an organ recipient, the donor's date of death is listed as the date that brain death was diagnosed. In some countries (for instance, Spain , Finland , the United Kingdom , Portugal , France , and by 2026 Switzerland ), everyone is automatically an organ donor after diagnosis of death on legally accepted criteria, although some jurisdictions (such as Singapore , Spain,

833-592: The brainstem . The distinctions are medically significant because, for example, in someone with a dead cerebrum but a living brainstem, spontaneous breathing may continue unaided, whereas in whole-brain death (which includes brainstem death ), only life support equipment would maintain ventilation . In certain countries, patients classified as brain-dead may legally have their organs surgically removed for organ donation . Differences in operational definitions of death have obvious medicolegal implications (in medical jurisprudence and medical law ). Traditionally, both

882-544: The caloric reflex test , and no spontaneous respirations . Brain death can sometimes be difficult to differentiate from other medical states such as barbiturate overdose , acute alcohol poisoning , sedative overdose, hypothermia , hypoglycemia , coma , and chronic vegetative states . Some comatose patients can recover to pre-coma or near pre-coma level of functioning, and some patients with severe irreversible neurological dysfunction will nonetheless retain some lower brain functions, such as spontaneous respiration, despite

931-409: The lateral sulcus that separates the temporal lobe from the parietal and frontal lobes, is located within each hemisphere of the mammalian brain. The cerebrum is divided by the medial longitudinal fissure into two cerebral hemispheres , the right and the left. The cerebrum is contralaterally organized , i.e., the right hemisphere controls and processes signals (predominantly) from the left side of

980-399: The telencephalon and the diencephalon . The dorsal telencephalon gives rise to the pallium (cerebral cortex in mammals and reptiles) and the ventral telencephalon generates the basal ganglia . The diencephalon develops into the thalamus and hypothalamus , including the optic vesicles (future retina ). The dorsal telencephalon then forms two lateral telencephalic vesicles, separated by

1029-503: The Federal Council of Medicine revised its regulations in 2017, including "a requirement for the patient to meet specific physiological prerequisites and for the physician to provide optimized care to the patient before starting the procedures for diagnosing brain death and to perform complementary tests, as well as the need for specific training for physicians who make this diagnosis." In 2020, an international panel of experts,

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1078-531: The United Kingdom, France, Czech Republic , Poland and Portugal) allow opting out of the system. Elsewhere, consent from family members or next-of-kin may be required for organ donation. In New Zealand , Australia and most states in the United States , drivers are asked upon application if they wish to be registered as an organ donor. In the United States, if the patient is at or near death,

1127-484: The World Brain Death Project, published a guideline that: provides recommendations for the minimum clinical standards for determination of brain death/death by neurologic criteria (BD/DNC) in adults and children with clear guidance for various clinical circumstances. The recommendations have widespread international society endorsement and can serve to guide professional societies and countries in

1176-475: The assistance of the cerebellum , the cerebrum controls all voluntary actions in the human body. The cerebrum is the largest part of the brain . Depending upon the position of the animal, it lies either in front or on top of the brainstem . In humans, the cerebrum is the largest and best-developed of the five major divisions of the brain. The cerebrum is made up of the two cerebral hemispheres and their cerebral cortices (the outer layers of grey matter ), and

1225-411: The body, while the left hemisphere controls and processes signals (predominantly) from the right side of the body. According to current knowledge, this is due to an axial twist that occurs in the early embryo . There is a strong but not complete bilateral symmetry between the hemispheres, while lateralization tends to increase with increasing brain size. The lateralization of brain function looks at

1274-415: The brain or brain stem; these cells come from the spinal cord. Sometimes these body movements can cause false hope for family members. A brain-dead individual has no clinical evidence of brain function upon physical examination . This includes no response to pain and no cranial nerve reflexes . Reflexes include pupillary response (fixed pupils), oculocephalic reflex , corneal reflex , no response to

1323-762: The brain, particularly within the first 72 hours, can lead to a false positive test on a patient that may recover with more time. CT angiography is neither required nor sufficient test to make the diagnosis. Confirmatory testing is only needed under the age of 1. For children and adults, testing is optional. Other situations possibly requiring confirmatory testing include severe facial trauma where determination of brainstem reflexes will be difficult, pre-existing pupillary abnormalities, and patients with severe sleep apnea and/or pulmonary disease. Confirmatory tests include: cerebral angiography, electroencephalography, transcranial Doppler ultrasonography, and cerebral scintigraphy (technetium Tc 99m exametazime). Cerebral angiography

1372-430: The cerebral surface (see gyrus , gyrification ) are also found only in higher mammals. Although some large mammals (such as elephants) have particularly large cerebra, dolphins are the only species (other than humans) to have cerebra accounting for as much as 2 percent of their body weight. The cerebra of birds are similarly enlarged to those of mammals, by comparison with reptiles. The increased size of bird brains

1421-434: The cerebrum as a whole serves. (See main articles on cerebral cortex and basal ganglia for more information.) The cerebrum is a major part of the brain, controlling emotions, hearing, vision, personality and much more. It controls all precision of voluntary actions. Upper motor neurons in the primary motor cortex send their axons to the brainstem and spinal cord to synapse on the lower motor neurons , which innervate

1470-444: The hippocampus. In the most primitive vertebrates, the hagfishes and lampreys , the cerebrum is a relatively simple structure receiving nerve impulses from the olfactory bulb . In cartilaginous and lobe-finned fishes and also in amphibians , a more complex structure is present, with the cerebrum being divided into three distinct regions. The lowermost (or ventral) region forms the basal nuclei , and contains fibres connecting

1519-487: The hospital must notify a designated Organ Procurement Organization (OPO) of the details, and maintain the patient while the patient is being evaluated for suitability as a donor. The OPO searches to see if the deceased is registered as a donor, which serves as legal consent; if the deceased has not registered or otherwise noted consent (e.g., on a driver's license), the OPO will ask the next of kin for authorization. The patient

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1568-402: The irreversible loss of the capacity for consciousness and for spontaneous breathing, and the essentially unchanged 1976 tests held to establish that state, have been adopted as a basis of death certification for organ transplant purposes in subsequent Codes of Practice. The Australia and New Zealand Intensive Care Society (ANZICS) states that the "determination of brain death requires that there

1617-417: The known and possible differences between the two. In the developing vertebrate embryo , the neural tube is subdivided into four unseparated sections which then develop further into distinct regions of the central nervous system ; these are the prosencephalon ( forebrain ), the mesencephalon ( midbrain ) the rhombencephalon ( hindbrain ) and the spinal cord . The prosencephalon develops further into

1666-409: The lateral and ventral regions of the cerebrum bulge up into the ventricles ; these include both the basal nuclei and the various parts of the pallium and may be complex in structure, especially in teleosts . The dorsal surface of the cerebrum is membranous, and does not contain any nervous tissue . In the amniotes, the cerebrum becomes increasingly large and complex. In reptiles , the paleopallium

1715-431: The legal and medical communities determined death through the permanent end of certain bodily functions in clinical death , especially respiration and heartbeat . With the increasing ability of the medical community to resuscitate people with no respiration, heartbeat, or other external signs of life, the need for another definition of death occurred, raising questions of legal death . This gained greater urgency with

1764-586: The link to point directly to the intended article. Retrieved from " https://en.wikipedia.org/w/index.php?title=Brain_Dead&oldid=1138225410 " Category : Disambiguation pages Hidden categories: Short description is different from Wikidata All article disambiguation pages All disambiguation pages brain-dead Brain death is the permanent, irreversible, and complete loss of brain function , which may include cessation of involuntary activity necessary to sustain life. It differs from persistent vegetative state , in which

1813-414: The losses of both cortex and brain stem functionality. Such is the case with anencephaly . Brain electrical activity can stop completely, or drop to such a low level as to be undetectable with most equipment. An EEG will therefore be flat, though this is sometimes also observed during deep anesthesia or cardiac arrest . Although in the United States a flat EEG test is not required to certify death, it

1862-431: The midline, which develop into the left and right cerebral hemispheres. Birds and fish have a dorsal telencephalon, like all vertebrates, but it is generally unlayered and therefore not considered a cerebral cortex. Only a layered cytoarchitecture can be considered a cortex. Note : As the cerebrum is a gross division with many subdivisions and sub-regions, it is important to state that this section lists only functions that

1911-626: The muscles. Damage to motor areas of the cortex can lead to certain types of motor neuron disease . This kind of damage results in loss of muscular power and precision rather than total paralysis . It functions as the center of sensory perception, memory, thoughts and judgement; the cerebrum also functions as the center of voluntary motor activities. The primary sensory areas of the cerebral cortex receive and process visual , auditory , somatosensory , gustatory , and olfactory information. Together with association cortical areas, these brain regions synthesize sensory information into our perceptions of

1960-437: The person is alive and some autonomic functions remain. It is also distinct from comas as long as some brain and bodily activity and function remain, and it is also not the same as the condition locked-in syndrome . A differential diagnosis can medically distinguish these differing conditions. Brain death is used as an indicator of legal death in many jurisdictions, but it is defined inconsistently and often confused by

2009-486: The public. Various parts of the brain may keep functioning when others do not anymore, and the term "brain death" has been used to refer to various combinations. For example, although one major medical dictionary considers "brain death" to be synonymous with "cerebral death" (death of the cerebrum ), the US National Library of Medicine Medical Subject Headings (MeSH) system defines brain death as including

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2058-425: The rest of the cerebrum to the thalamus. Above this, and forming the lateral part of the cerebrum, is the paleopallium , while the uppermost (or dorsal) part is referred to as the archipallium . The cerebrum remains largely devoted to olfactory sensation in these animals, in contrast to its much wider range of functions in amniotes . In ray-finned fishes , the structure is somewhat different. The inner surfaces of

2107-467: The revision or development of protocols and procedures for determination of brain death/death by neurologic criteria, leading to greater consistency within and between countries. Natural movements also known as the Lazarus sign or Lazarus reflex can occur on a brain-dead person whose organs have been kept functioning by life support. The living cells that can cause these movements are not living cells from

2156-430: The state of Kansas had enacted a similar law earlier. An ad hoc committee at Harvard Medical School published a pivotal 1968 report to define irreversible coma . The Harvard criteria gradually gained consensus toward what is now known as brain death. In the wake of the 1976 Karen Ann Quinlan case , state legislatures in the United States moved to accept brain death as an acceptable indication of death. In 1981,

2205-410: The surface of the cerebral cortex folds to create gyri (ridges) and sulci (furrows) which increase the surface area . The cerebral cortex is generally classified into four lobes : the frontal , parietal , occipital and temporal lobes. The lobes are classified based on their overlying neurocranial bones . A smaller lobe is the insular lobe , a part of the cerebral cortex folded deep within

2254-403: The underlying regions of white matter . Its subcortical structures include the hippocampus, basal ganglia and olfactory bulb. The cerebrum consists of two C-shaped cerebral hemispheres, separated from each other by a deep fissure called the longitudinal fissure . The cerebral cortex , the outer layer of grey matter of the cerebrum, is found only in mammals. In larger mammals, including humans,

2303-425: The whole of the cerebral hemispheres, especially in more developed species, such as the primates . The paleopallium is pushed to the ventral surface of the brain, where it becomes the olfactory lobes, while the archipallium becomes rolled over at the medial dorsal edge to form the hippocampus . In placental mammals , a corpus callosum also develops, further connecting the two hemispheres. The complex convolutions of

2352-410: The widespread use of life support equipment and the rising capabilities and demand for organ transplantation . Since the 1960s, laws governing the determination of death have been implemented in all countries that have active organ transplantation programs. The first European country to adopt brain death as a legal definition (or indicator) of death was Finland in 1971, while in the United States ,

2401-405: The world. The olfactory bulb , responsible for the sense of smell, takes up a large area of the cerebrum in most vertebrates. However, in humans, this part of the brain is much smaller and lies underneath the frontal lobe. The olfactory sensory system is unique since the neurons in the olfactory bulb send their axons directly to the olfactory cortex , rather than to the thalamus first. Olfaction

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