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Fortschr Neurol Psychiatr · Jun 2016
Case Reports[Subarachnoid Hemorrhage and Isolated Brainstem Death].
- C Roth and A Ferbert.
- Fortschr Neurol Psychiatr. 2016 Jun 1; 84 (6): 377-84.
BackgroundWorldwide there are differences in the procedure of determining brain death. An irreversible loss of all brain functions, including cerebrum, cerebellum and brainstem is mandatory for the diagnosis of brain death in Germany. On the basis of a case report some important aspects of the new recommendations of the German guidelines are discussed.Case ReportWe present the case of a 41-year old patient who was admitted to our clinic due to acute subarachnoid hemorrhage (SAH). Angiography revealed an aneurysm of the posterior inferior cerebellar artery. The patient was comatose without any brainstem reflexes and showed apnoea. However, on day 3, EEG showed alpha activity as a sign of residual cortical function. We diagnosed an isolated brainstem death. The next day EEG was isoelectric and brain death was confirmed.DiscussionThe diagnosis of isolated brainstem death does not allow a confirmation of death in Germany. Our case presents a primary infratentorial brain damage mandating additional confirmatory tests.© Georg Thieme Verlag KG Stuttgart · New York.
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