English term brain death, cerebral death
Definition
The term brain death is understood to mean the non-existent and irreversible activity of vital brain areas (cerebrum, cerebellum, brain stem) during cardiovascular function still maintained by artificial respiration (Scientific Advisory Council of the German Medical Association, 1997). Brain death in the scientific-medical sense means the death of a human being. Frontal lobe = red (frontal lobe, frontal lobe) Parietal lobe = blue (parietal lobe, parietal lobe) Occipital lobe = green (occiptital lobe, occipital lobe) Temporal lobe = yellow (temporal lobe, temporal lobe).
To determine the irreversibility of brain activity, certain medical examinations as well as instrumental procedures and certain observation times are required. The scientific advisory board of the German Medical Association (1997) publishes the following guidelines for the diagnosis of brain death:
- Requirements To determine brain death, there must be either primary (severe head injury, etc.) or secondary brain damage (due to lack of oxygen, etc.).
Furthermore, intoxications and pathological processes must be excluded.
- Symptoms for the loss of brain function are unconsciousness (coma), light rigidity of the pupil (pupils no longer react to light stimuli), lack of reflexes and lack of spontaneous breathing.
- Irreversibility of failure symptoms
- The observation period of the failure symptoms must be between 12 hours and three days. Additional instrumental examinations are necessary to diagnose brain death. One such instrumental method is electroencephalography (EEG), which records the activity of the brain.
If the electroencephalogram shows neither a basic activity (zero line finding) nor a reaction to visual, auditory or tactile stimuli (evoked potentials, EP), and if no blood circulation in the large vessels (arteries and veins) can be determined by Doppler sonography, these findings confirm in conjunction with the other examinations that brain death has occurred.
- The observation period of the failure symptoms in newborns must be 72 hours, in infants and toddlers 24 hours, with additional diagnostics by EEG, EP, Doppler sonography.
Contrary to the assumption that the time of death is the time of death, in the true sense it means the time of completion of the diagnosis and documentation of brain death. Neither of the two doctors who diagnose brain death may subsequently participate in organ transplantation. Only after brain death has been diagnosed (guidelines of the German Medical Association 1997, see above) may the removal of tissue or organs be carried out within the framework of §3 of the Transplantation Act, provided that the deceased person or the relatives have not objected to the removal of the organ/tissue.
