Neuroanesthesia & neurocritical care
Infratentorial brain injury and death by neurologic criteria in Canada: a narrative review
Authors' conclusion
On this basis, IBI consistent with clinical signs of death by neurologic criteria without significant supratentorial involvement does not fulfill criteria for death in Canada and ancillary testing is required.
Study context
- Population
- Patients with infratentorial brain injury (IBI) and clinical signs of death by neurologic criteria, Canada
Methodological detailsexpert working group, Part of the Canadian Death Definition and Determination Project
- Expert working group
- Part of the Canadian Death Definition and Determination Project
Main finding
As reported in the abstract
- Clinical determination of death cannot distinguish IBI from whole-brain cessation of function
- Current clinical, functional and neuroimaging assessments cannot reliably confirm complete and permanent destruction of the brainstem
- No patient with isolated brainstem death reported to recover consciousness; all patients died
- Significant majority of isolated brainstem death evolves into whole-brain death, influenced by duration of somatic support and impacted by ventricular drainage and/or posterior fossa decompressive craniectomy
- No reliable ancillary test to confirm complete destruction of the brainstem
Further findings
Canadian intensive care unit (ICU) physician practice
- Majority of Canadian ICU physicians would perform ancillary testing for death determination in IBI, with variability in opinion
Original publication
Infratentorial brain injury and death by neurologic criteria in Canada: a narrative review. Can J Anaesth. Published 3 May 2023. doi:10.
Composed by AI from the published abstract and checked against it. How Briefs are made →