Abstract

PREVIGLIANO, Ignacio J.. Diagnóstico de muerte encefálica: evitando errores. Rev. argent. neurocir. [online]. 2007, vol.21, n.1. ISSN 1850-1532.

The diagnosis of encephalic death (ED) is a clinical process and a legal responsibility. It implies the definitive abolition of cortical and brainstem functions. Diagnostic steps: 1) Previous necessary conditions: - extensive structural damage proved by neuroimaging: a) coma and prolonged apnea; b) no drug effects (depressants or relaxants); c) > 32 ° C temperature; d) > 90 mm Hg SBP; e) no metabolic and/ or endocrinologic disturbances. 2) Neurological findings: GCS 3/15. Middle or dilated arreactive pupils. No corneal reflex or mimic to pain. Absence of spontaneous or reflex ocular movements. Abolition of bulbar reflexes and definitive apnea proved by the "apneic oxigenation test". 3) Auxiliary methods: a) flow arrest: cerebral angiography, TCD, radioisotopic angiography. b) electrophysiologic test: EEG and evoked potentials (auditive and somatosensitive). 4) Reexamination after some delay depending on the age of the patient, to confirm the findings. The most common cause of error is the unobsevancy of the previous necessary conditions.

Keywords : Encephalic death; Craniocerebral trauma.

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