Nō to shinkei = Brain and nerve
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In the diagnosis of brain death, it is generally accepted that respiratory function has to be absent, however, spinal reflexes can be preserved. We presented a patient who showed a complex movements of upper limbs (Lazarus' sign) and respiratory like movement during the apnea test for the determination of brain death. This 72-year old female admitted to our hospital in a semicomatous state due to severe subarachnoid and ventricular hemorrhage. ⋯ These movements ceased immediately after connecting the respirator. These two types of movements were reproducible except for in the final test. Blood pressure gradually decreased, and cardiac arrest occurred one hour after.(ABSTRACT TRUNCATED AT 250 WORDS)
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Traumatic subarachnoid hemorrhage (TSAH) is a frequent occurrence resulting from acute severe head injury. Computerized tomography (CT) accurately identifies the region, extent and nature of TSAH following trauma. But, to our knowledge, there have been few series detailing the characteristics of TSAH in acute severe head injury. ⋯ TSAH therefore appears to be seen in all age groups, but especially in middle age groups. The GCS on admission was 8 or less in all cases; the GCS was 8 in 10 cases, 7 in 7 cases, 6 in 15 cases, 5 in 16 cases, 4 in 23 cases, 3 in 26 cases. The lower GCS scores, the more frequently TSAH was identified, and 67% of the patients had a GCS of 6 or less.(ABSTRACT TRUNCATED AT 250 WORDS)