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In 2020, an international panel of experts, the World Brain Death Project, published a guideline that: [21] 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 change of use, in the UK, to criteria for the diagnosis of death itself was protested immediately. [17] [18] The initial basis for the change of use was the claim that satisfaction of the criteria sufficed for the diagnosis of the death of the brain as a whole, despite the persistence of demonstrable activity in parts of the brain. [19]
The phenomenon has been observed to occur several minutes after the removal of medical ventilators used to pump air in and out of brain-dead patients. [4] It also occurs during testing for apnea—that is, suspension of external breathing and motion of the lung muscles—which is one of the criteria for determining brain death used for example by the American Academy of Neurology.
Per the United Kingdom Medical Royal Colleges, a diagnosis of brain death is a two-fold process including 1) identifying the cause of irreversible brain damage and excluding reversible causes of brain damage and 2) conducting a series of clinical and laboratory tests to assess brain stem function. [7] [8]
Traumatic brain injury is defined as damage to the brain resulting from external mechanical force, such as rapid acceleration or deceleration, impact, blast waves, or penetration by a projectile. [10] Brain function is temporarily or permanently impaired and structural damage may or may not be detectable with current technology. [11]
This confirms the absence of neuronal function in the whole brain. Patients classified as brain dead are legally dead and can qualify as organ donors, in which their organs are surgically removed and prepared for a particular recipient. [citation needed] Brain death is one of the deciding factors when pronouncing a trauma patient as dead.
This diagnosis is classified as a permanent vegetative state some months (three in the US and six in the UK) after a non-traumatic brain injury or one year after a traumatic injury. The term unresponsive wakefulness syndrome may be used alternatively, [ 2 ] as "vegetative state" has some negative connotations among the public.
The test is commonly used by physicians, audiologists and other trained professionals to validate a diagnosis of asymmetric function in the peripheral vestibular system. Calorics are usually a subtest of the electronystagmography (ENG) battery of tests. It is one of several tests which can be used to test for brain stem death.