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Brain Stem Death


Brain Stem Death

When the brain stem, a component of the brain, stops functioning, this is known as brain stem death. The person will never be able to be conscious or breathe without a machine if the brain stem ceases functioning (ventilator). When a person’s brain stem stops functioning, they are officially declared dead.

Confirmation of death

It used to be less complicated to confirm death. It was once believed that a person died when their breathing, heart, and reflexes stopped. The brain stem stopped functioning permanently as a result of the shortage of oxygen that resulted from the blood flow interruption.

Because the heart can continue to beat even after the brain stem has irreversibly stopped working, confirming death has become more difficult. This is achieved by keeping the patient on a ventilator, which keeps the body and heart getting oxygen. That individual won’t ever wake up or breathe on their own again.

There is no way to reverse the permanent loss of brain stem function, and even if a ventilator is kept running, the heart will eventually stop beating.

Once there is no doubt that brain death has happened, the patient will be removed from the ventilator to spare their loved ones from needless suffering.

The brain stem

The bottom portion of the brain that connects to the spinal cord is called the brain stem (part of the central nervous system in the spinal column).

The majority of the body’s autonomic processes, which are vital to life, are controlled by the brain stem. These consist of:

  • Heartbeat
  • Breathing
  • Blood pressure
  • Swallowing

The brain stem is crucial to the main operations of the brain, including consciousness, awareness, and movement. It also transmits information to and from the brain to the rest of the body.

It is impossible for someone to be conscious after brain death.

How brain death occurs

When the brain’s supply of blood and oxygen is cut off, brain death may result. This may be brought on by:

  • Cardiac arrest – When the heart stops beating and the brain runs out of oxygen, it is known as cardiac arrest.
  • Heart attack – A critical medical emergency happens when the heart’s blood supply is unexpectedly cut off.
  • Stroke – A critical medical emergency called a stroke happens when the blood flow to the brain is cut off or disrupted.
  • Blood clots – Obstructions in blood vessels that interfere with or obstruct blood movement throughout your body.

Additional causes of brain death include:

  • A severe head injury
  • A brain tumour
  • A brain haemorrhage
  • Infections, such as encephalitis


Vegetative state

A vegetative state, which can happen after severe brain damage, is distinct from brain death.

A person in a vegetative state can exhibit alertness symptoms, like opening their eyes, but they won’t react to their environment.

Rarely, a person may exhibit a brain scan-detectable sense of reaction but be unable to interact with their environment.

The crucial distinction between a vegetative state and brain death is that a person in a vegetative state still has a functioning brain stem, which means that:

  • There may be some form of consciousness.
  • Unassisted breathing is usually achievable.
  • Recovery is unlikely because the brain stem’s fundamental functions might be unaffected.

If a person is brain dead, there is little possibility for recovery because their body cannot function without assistance.

Confirming brain death

A few things, though uncommon, can give the impression that someone is brain-dead.

Among these are extreme hypothermia (where the body temperature drops below 28C) and drug overdoses, particularly those caused by barbiturates.

The presence of brain death is verified using a variety of techniques, such as flashing a torch into both eyes to examine if either eye responds to the light.


Organ donation

After brain death, it may be feasible to use the deceased’s organs in transplants, which frequently help save the lives of other people.

It might be challenging for partners and family members to decide whether to donate the organs of the deceased when that individual hasn’t made their preferences clear. The medical personnel will make an effort to treat the situation sensitively and thoughtfully because they are aware of how difficult these decisions can be.