View source for Brain death

{{short description|Permanent loss of brain function}}
{{for|the EP by Nuclear Assault|Brain Death (EP)}}
{{Redirect|Brain-dead||Brain Dead (disambiguation){{!}}Brain Dead}}
{{use dmy dates|date=September 2023}}
{{Infobox medical condition
| name = Brain death
| synonym = Brain stem death
| image = Brain Death - Lazarus sign - Rare exuberant spinal reflex exclusively elicited per head flexion (TubeRipper.com).webm
| alt = A video of a brain-dead boy. The same boy executes the [[Lazarus sign]] twice.
| caption = A brain-dead patient. The patient can also be seen here executing the [[Lazarus sign]].
| specialty = [[Neurology]], [[neurosurgery]], [[palliative care]], [[Intensive care medicine|critical care medicine]]
| causes = [[Cardiac arrest]], [[myocardial infarction]], [[stroke]], [[Thrombus|blood clot]]
| diagnosis = [[Stimulation]] testing, [[Electroencephalography|EEG]], [[Pupillary response|pupil reactivity]] test
| treatment = Artificial [[life support]]
| prognosis = 100% mortality, brain death is irreversible
| frequency = Rare
| deaths = 15,000 to 20,000
| complications = [[Multiple organ dysfunction syndrome|Total organ failure]]
}}
'''Brain death''' is the permanent, irreversible, and complete loss of [[Electroencephalography|brain function]], which may include cessation of involuntary activity (e.g., [[Control of ventilation#Control of respiratory rhythm|breathing]]) necessary to sustain life.<ref name="enc bd">{{cite encyclopedia|url=http://www.deathreference.com/Bl-Ce/Brain-Death.html |title=Brain death| encyclopedia=Encyclopedia of Death and Dying| access-date= 25 March 2014}}</ref><ref name=":0">{{cite web| url=http://www.uptodate.com/contents/diagnosis-of-brain-death | title=Diagnosis of brain death| last=Young | first= G Bryan| work=UpToDate|access-date=25 March 2014}}</ref><ref>{{Cite journal | doi = 10.4103/0972-5229.53108| pmid = 19881172| title = The diagnosis of brain death| journal = Indian Journal of Critical Care Medicine| volume = 13| issue = 1| pages = 7–11| year = 2009| last1 = Goila | first1 = A. | last2 = Pawar | first2 = M. | pmc = 2772257| doi-access = free}}</ref><ref>{{Cite journal | doi = 10.4081/ni.2010.e2| pmid = 21577338| pmc = 3093212| title = Diagnosis of brain death| journal = Neurology International| volume = 2| issue = 1| page = 2| year = 2010| last1 = Machado | first1 = C. }}</ref><ref name="Wijdicks_Page_131">{{cite book |last1=Wijdicks |first1=Eelco F.M. |title=The Comatose Patient |date=2014 |publisher=Oxford University Press |location=Oxford |isbn=9780199331239 |page=131 |url=https://books.google.com/books?id=HpCtAwAAQBAJ&pg=PA131}}</ref> It differs from [[persistent vegetative state]], in which the person is alive and some autonomic functions remain.<ref>{{cite journal |title=Medical aspects of the persistent vegetative state (1) |journal=N. Engl. J. Med. |volume=330 |issue=21 |pages=1499–508 |date=May 1994 |pmid=7818633 |doi=10.1056/NEJM199405263302107 |author1=Multi-Society Task Force on PVS |doi-access=free }}</ref> It is also distinct from [[coma]]s as long as some brain and bodily activity and function remain, and it is also not the same as the condition [[locked-in syndrome]]. A [[differential diagnosis]] can medically distinguish these differing conditions.

Brain death is used as an indicator of [[legal death]] in many jurisdictions,<ref>{{cite web | url=https://www.nhs.uk/conditions/brain-death/#:~:text=Brain%20death%20(also%20known%20as,is%20legally%20confirmed%20as%20dead | title=Brain death | date=20 October 2017 }}</ref> but it is [[Medical definition of death|defined]] inconsistently and often confused by the public.<ref>{{cite journal |vauthors=Jones AH, Dizon ZB, October TW |title=Investigation of Public Perception of Brain Death Using the Internet |journal=Chest |volume=154 |issue=2 |pages=286–292 |date=August 2018 |pmid=29382473 |pmc=7339235 |doi=10.1016/j.chest.2018.01.021 }}</ref> Various parts of the brain may keep functioning when others do not anymore,  bringing questions about whether they should truly be considered dead. The term "brain death" has been used to refer to various combinations. For example, although one major medical dictionary considers "brain death" to be synonymous with "cerebral death" (death of the [[cerebrum]]),<ref name="Dorlands">{{Citation |author=Elsevier |author-link=Elsevier |title=Dorland's Illustrated Medical Dictionary |publisher=Elsevier |url=http://dorlands.com/ |postscript=. |access-date=2015-07-20 |archive-date=2014-01-11 |archive-url=https://web.archive.org/web/20140111192614/http://dorlands.com/ }}</ref> the US National Library of Medicine [[Medical Subject Headings]] (MeSH) system defines brain death as including the [[brainstem]]. The distinctions are medically significant because, for example, in someone with a dead cerebrum but a living brainstem, spontaneous breathing may continue unaided, whereas in whole-brain death (which includes [[brainstem death]]), only [[life support]] equipment would maintain [[ventilation (physiology)|ventilation]]. In certain countries, patients classified as brain-dead may legally have their organs surgically removed for [[organ donation]].{{Citation needed|date=March 2023}}

==Medicolegal history==

Brain death is a medicolegal death of a person due to the complete and irreversible loss of all brain functions, including the brain stem. The definition of brain death is accepted in numerous regions, it is one of the most complicated topics in medical ethics today. In [[operational definition]]s of death have obvious medicolegal implications (in [[medical jurisprudence]] and [[medical law]]). Traditionally, both the legal and medical communities determined [[death]] through the permanent end of certain [[Human body|bodily]] functions in [[clinical death]], especially [[Respiration (physiology)|respiration]] and [[Cardiac cycle|heartbeat]]. With the increasing ability of the medical community to [[resuscitate]] people with no respiration, heartbeat, or other external signs of life, the need for another definition of death occurred, raising questions of [[legal death]]. This gained greater urgency with the widespread use of [[life support]] equipment and the rising capabilities and demand for [[organ transplantation]].

Since the 1960s, laws governing the determination of death have been implemented in all countries that have active organ transplantation programs. The first European country to adopt brain death as a legal definition (or indicator) of death was [[Finland]] in 1971, while in the [[United States]], the state of [[Kansas]] had enacted a similar law earlier.<ref name=":1">{{cite journal | author=(Randell T. | title=Medical and legal considerations of brain death | journal=Acta Anaesthesiologica Scandinavica | volume=48 | issue=2 | year=2004 | pages=139–44 | pmid=14995934 | doi=10.1111/j.0001-5172.2004.00304.x| s2cid=38019096 }}</ref>

An ''[[ad hoc]]'' committee at [[Harvard Medical School]] published a pivotal 1968 report to define irreversible [[coma]].<ref>{{cite journal | year = 1968 | title = A definition of irreversible coma: report of the Ad Hoc Committee of the Harvard Medical School to Examine the Definition of Brain Death | journal = JAMA | volume = 205 | issue = 6| pages = 337–40 | doi=10.1001/jama.1968.03140320031009| pmid = 5694976 }}</ref><ref>{{cite book|url=https://books.google.com/books?id=rAz4nl35KkIC&pg=PA59|title=Life-sustaining technologies and the elderly.|publisher=Diane Publishing|via=Google Books|isbn=978-1-4289-2281-5|year=1987}}</ref> The Harvard criteria gradually gained consensus toward what is now known as brain death. In the wake of the 1976 [[Karen Ann Quinlan case]], state legislatures in the United States moved to accept brain death as an acceptable indication of death. In 1981, a [[Presidential Commission (United States)|presidential commission]] issued a landmark report entitled ''Defining Death: Medical, Legal, and Ethical Issues in the Determination of Death'',<ref>{{cite book |title=Defining death: a report on the medical, legal and ethical issues in the determination of death |publisher=President's Commission for the Study of Ethical Problems in Medicine and Biomedical and Behavioral Research |hdl=1805/707 |hdl-access=free |date=July 1981}}</ref> which rejected the "higher-brain" approach to death in favor of a "whole-brain" definition. This report formed the basis for the [[Uniform Determination of Death Act]], since enacted in 39 states.<ref>{{cite web|title=Legislative Fact Sheet – Determination of Death Act|url=http://uniformlaws.org/LegislativeFactSheet.aspx?title=Determination%20of%20Death%20Act|archive-url=https://web.archive.org/web/20120201163046/http://uniformlaws.org/LegislativeFactSheet.aspx?title=Determination%20of%20Death%20Act|url-status=dead|archive-date=1 February 2012|publisher=Uniform Law Commission|access-date=8 May 2012}}</ref> Today, both the legal and medical communities in the US use "brain death" as a legal definition of death, allowing a person to be declared [[legal death|legally dead]] even if life support equipment maintains the body's [[metabolic process]]es.<ref>{{cite web| url=http://pntb.org/wordpress/wp-content/uploads/Uniform-Determination-of-Death-1980_5c.pdf| title=Uniform Determination of Death Act| publisher=National Conference of Commissioners on Uniform State Laws| access-date=26 March 2014| archive-url=https://web.archive.org/web/20160304131421/http://pntb.org/wordpress/wp-content/uploads/Uniform-Determination-of-Death-1980_5c.pdf| archive-date=4 March 2016}}</ref>

In the UK, the [[Royal College of Physicians]] reported in 1995, abandoning the 1979 claim that the tests published in 1976 sufficed for the diagnosis of brain death, and suggesting a new definition of death based on the irreversible loss of brain-stem function alone.<ref>{{cite journal |title=Criteria for the diagnosis of brain stem death. Review by a working group convened by the Royal College of Physicians and endorsed by the Conference of Medical Royal Colleges and their Faculties in the United Kingdom |journal=J R Coll Physicians Lond |volume=29 |issue=5 |pages=381–82 |date=1995 |pmid=8847677 |pmc=5401215 }}</ref> This new definition, the irreversible loss of the capacity for consciousness and for spontaneous breathing, and the essentially unchanged 1976 tests held to establish that state, have been adopted as a basis of death certification for organ transplant purposes in subsequent Codes of Practice.<ref>"A Code of Practice for the Diagnosis and Confirmation of Death." Academy of Medical Royal Colleges, London, 2008</ref><ref>American Academy of Neurology. (2000, January 13).Spontaneous Movements Often Occur After Brain Death. Science Daily.</ref> The Australia and New Zealand Intensive Care Society (ANZICS) states that the "determination of brain death requires that there is unresponsive coma, the absence of brain-stem reflexes and the absence of respiratory centre function, in the clinical setting in which these findings are irreversible. In particular, there must be definite clinical or [[Neuroimaging|neuro-imaging]] evidence of acute brain pathology (e.g. traumatic brain injury, intracranial haemorrhage, hypoxic encephalopathy) consistent with the irreversible loss of neurological function."<ref>{{cite book|url=http://www.anzics.com.au/Downloads/ANZICS%20Statement%20on%20%20Death%20and%20Organ%20Donation%20Edition%203.2.pdf|title=The ANZICS Statement on Death and Organ Donation|publisher=Australian and New Zealand Intensive Care Society|edition=3.2|location=Melbourne|year=2013|page=17|isbn=978-1-876980-21-4|archive-url=https://web.archive.org/web/20180319202056/http://www.anzics.com.au/Downloads/ANZICS%20Statement%20on%20%20Death%20and%20Organ%20Donation%20Edition%203.2.pdf|archive-date=March 19, 2018}}</ref>  In Brazil, the Federal Council of Medicine revised its regulations in 2017, including "a requirement for the patient to meet specific physiological prerequisites and for the physician to provide optimized care to the patient before starting the procedures for diagnosing brain death and to perform complementary tests, as well as the need for specific training for physicians who make this diagnosis."<ref>{{Cite journal|last1=Westphal|first1=Glauco Adrieno|last2=Veiga|first2=Viviane Cordeiro|last3=Franke|first3=Cristiano Augusto|date=July–September 2019|title=Diagnosis of brain death in Brazil|journal=Revista Brasileira de terapia intensiva.|volume=31|issue=3|pages=403–09|doi=10.5935/0103-507X.20190050|pmc=7005965|pmid=31618361}}</ref>

In 2020, an international panel of experts, the World Brain Death Project, published a [[medical guideline|guideline]] that:<ref name="pmid-32761206">{{cite journal |last1=Greer |first1=DM |last2=Shemie |first2=SD |last3=Lewis |first3=A |last4=Torrance |first4=S |last5=Varelas |first5=P |last6=Goldenberg |first6=FD |display-authors=et al |title=Determination of Brain Death/Death by Neurologic Criteria: The World Brain Death Project. |journal=JAMA |date=15 September 2020 |volume=324 |issue=11 |pages=1078–97 |doi=10.1001/jama.2020.11586 |pmid=32761206|s2cid=221038198 }}</ref><blockquote>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 recommendations have widespread international society endorsement and can serve to guide professional societies and countries in the revision or development of protocols and procedures for determination of brain death/death by neurologic criteria, leading to greater consistency within and between countries. 

The World Brain Death Project, published in 2020 by Greer et al., provides some of the most comprehensive and globally recognized recommendations for determining brain death. Their *JAMA* The agreement statement offers detailed evidence in protocols for diagnosing brain death in adults and children. It focuses on a standard clinical process, additional testing when necessary, and special considerations in difficult cases. One of the project's main goals is to reduce variability in brain death diagnosis by creating a consistent, internationally framework (Greer et al., 2020). </blockquote>

==Medical criteria==
Natural movements also known as the [[Lazarus sign]] or Lazarus reflex can occur on a brain-dead person whose organs have been kept functioning by life support. The living cells that can cause these movements are not living cells from the brain or brain stem; these cells come from the [[Spinal cord#Other functions|spinal cord]]. Sometimes these body movements can cause false hope for family members.

A brain-dead individual has no clinical evidence of brain function upon [[physical examination]]. This includes no response to [[pain]] and no [[cranial nerve]] [[reflex]]es. Reflexes include [[Pupil constriction|pupillary response]] (fixed pupils), [[oculocephalic reflex]], [[corneal reflex]], no response to the [[caloric reflex test]], and no spontaneous [[Respiratory system|respiration]]s.

Brain death can sometimes be difficult to differentiate from other medical states such as [[barbiturate overdose]], acute [[alcohol poisoning]], [[sedative]] overdose, [[hypothermia]], [[hypoglycemia]], [[coma]], and chronic [[vegetative states]]. Some comatose patients can recover to pre-coma or near pre-coma level of functioning, and some patients with severe irreversible neurological dysfunction will nonetheless retain some lower brain functions, such as spontaneous respiration, despite the losses of both cortex and brain stem functionality. Such is the case with [[anencephaly]].

Brain electrical activity can stop completely, or drop to such a low level as to be undetectable with most equipment. An [[electroencephalogram|EEG]] will therefore be flat, though this is sometimes also observed during deep [[anesthesia]] or [[cardiac arrest]].<ref>{{cite journal | last1 = Karasawa | first1 = H | display-authors = etal   | date = Jan 2001 | title = Intracranial electroencephalographic changes in deep anesthesia | journal = Clin Neurophysiol | volume = 112 | issue = 1| pages = 25–30 | pmid = 11137657 | doi=10.1016/s1388-2457(00)00510-1| s2cid = 30912230 }}</ref> Although in the United States a flat EEG test is not required to certify death, it is considered to have confirmatory value. In the UK it is not considered to be of value because any continuing activity it might reveal in parts of the brain above the brain stem is held to be irrelevant to the diagnosis of death on the Code of Practice criteria.<ref>"A Code of Practice for the Diagnosis of Death". Academy of Medical Royal Colleges, London, 2008</ref>

The diagnosis of brain death is often required to be highly rigorous, in order to be certain that the condition is irreversible. Legal criteria vary, but in general require neurological examinations by two independent physicians. The exams must show complete and irreversible absence of brain function (brain stem function in UK),<ref>{{cite journal |title=Difficulty in brainstem death testing in the presence of high spinal cord injury |first1=C. E. |last1=Waters |first2=G. |last2=French |first3=M. |last3=Burt |journal=British Journal of Anaesthesia |volume=92 |issue=5 |pages=760–64 |doi=10.1093/bja/aeh117|pmid=15113764 |year=2004 |doi-access=free }}</ref> and may include two isoelectric (flat-line) EEGs 24&nbsp;hours apart (less in other countries where it is accepted that if the cause of the dysfunction is a clear physical trauma there is no need to wait that long to establish irreversibility). The patient should have a normal temperature and be free of drugs that can suppress brain activity if the diagnosis is to be made on EEG criteria.

[[File:Radionuclide Cerebral Blood Flow Scan.png|thumb|Radionuclide scan: No intracranial blood flow. The [[Hot nose sign|"hot-nose" sign]] is shown.]]
Also, a [[radionuclide]] cerebral blood flow scan that shows complete absence of intracranial blood flow must be considered with other exams – temporary swelling of the brain, particularly within the first 72 hours, can lead to a false positive test on a patient that may recover with more time.<ref>{{cite web|url=http://theness.com/neurologicablog/index.php/brain-dead/|title=Brain Dead – NeuroLogica Blog|website=theness.com|date=2008-04-08}}</ref>

[[CT angiography]] is neither required nor sufficient test to make the diagnosis.<ref>{{cite journal|last1=Taylor|first1=T|last2=Dineen|first2=RA|last3=Gardiner|first3=DC|last4=Buss|first4=CH|last5=Howatson|first5=A|last6=Pace|first6=NL|title=Computed tomography (CT) angiography for confirmation of the clinical diagnosis of brain death.|journal=The Cochrane Database of Systematic Reviews|date=Mar 31, 2014|volume=3|issue=3|pages=CD009694|pmid=24683063|doi=10.1002/14651858.CD009694.pub2|pmc=6517290}}</ref>

Confirmatory testing is only needed under the age of 1.<ref name=":0" /> For children and adults, testing is optional.  Other situations possibly requiring confirmatory testing include severe facial trauma where determination of brainstem reflexes will be difficult, pre-existing pupillary abnormalities, and patients with severe sleep apnea and/or pulmonary disease.<ref name=":0" /> Confirmatory tests include: cerebral angiography, electroencephalography, transcranial Doppler ultrasonography, and cerebral scintigraphy (technetium Tc 99m exametazime).  Cerebral angiography is considered the most sensitive confirmatory test in the determination of brain death.<ref name=":0" />

==Organ donation==
{{Main|Organ donation}}
While the diagnosis of brain death has become accepted as a basis for the certification of death for legal purposes, it is a very different state from [[biological death]] – the state universally recognized and understood as death.<ref>Truog RD, Miller FG. The meaning of brain death. JAMA Internal Medicine 2014, Publ online June 9, 2014 : {{doi|10.1001/jamainternmed.2014.2272}}</ref> The continuing function of vital organs in the bodies of those diagnosed brain-dead, if mechanical ventilation and other life-support measures are continued, provides optimal opportunities for their transplantation.

When mechanical ventilation is used to support the body of a brain-dead organ donor pending a transplant into an organ recipient, the donor's date of death is listed as the date that brain death was diagnosed.<ref>{{cite web|title=Understanding Brain Death|date=29 September 2011|url=http://www.donorrecovery.org/learn/understanding-brain-death/|quote=What is the legal time of death for a brain dead patient?  The legal time of death is the date and time that doctors determine that all brain activity has ceased. This is the time that is noted on the patient's death certificate.}}</ref>

In some countries (for instance, [[Spain]],<ref>{{Cite web|title=Donación|url=http://www.ont.es/informacion/Paginas/Donaci%C3%B3n.aspx|access-date=1 April 2021|website=Organización Nacional de Trasplantes|language=es|archive-date=4 July 2017|archive-url=https://web.archive.org/web/20170704233551/http://www.ont.es/informacion/Paginas/Donaci%C3%B3n.aspx|url-status=dead}}</ref> [[Finland]], the [[United Kingdom]],<ref>{{cite web | url=https://www.organdonation.nhs.uk/helping-you-to-decide/organ-donation-laws/ | title=UK laws }}</ref> [[Portugal]], [[France]], and by 2026 [[Switzerland]]), everyone is automatically an organ donor after diagnosis of death on legally accepted criteria, although some jurisdictions (such as [[Singapore]], Spain, the United Kingdom, France, [[Czech Republic]], [[Poland]] and Portugal) allow opting out of the system. Elsewhere, consent from family members or next-of-kin may be required for organ donation. In [[New Zealand]], [[Australia]] and most states in the [[United States]], drivers are asked upon application if they wish to be registered as an organ donor.<ref>{{cite web|title=National Donate Life America Donor Designation State Report Card 2013|url=http://donatelife.net/wp-content/uploads/2013/07/DLA_ReportCardFinal_2013.pdf|pages=6 & 7|quote=2012 State Comparisons|archive-url=https://web.archive.org/web/20140322222952/http://donatelife.net/wp-content/uploads/2013/07/DLA_ReportCardFinal_2013.pdf|archive-date=2014-03-22}}</ref>

In the United States, if the patient is at or near death, the hospital must notify a designated [[Organ procurement organization|Organ Procurement Organization]] (OPO) of the details, and maintain the patient while the patient is being evaluated for suitability as a donor.<ref>{{cite web|title=State and Federal Law on Organ Procurement|url=http://www.wsha.org/EOL-OrganProcurement.cfm|quote=Unless the individual expressed contrary intent, a hospital must take measures to ensure the medical suitability of an individual at or near death while a procurement organization examines the patient for suitability as a donor.|archive-url=https://web.archive.org/web/20140306072928/http://www.wsha.org/EOL-OrganProcurement.cfm|archive-date=2014-03-06}}</ref> The OPO searches to see if the deceased is registered as a donor, which serves as legal consent; if the deceased has not registered or otherwise noted consent (e.g., on a driver's license), the OPO will ask the next of kin for authorization.<ref>{{Cite web|title=The Deceased Donation Process|url=https://www.organdonor.gov/about/process/deceased-donation.html|access-date=1 April 2021|website=Organdonor.gov}}</ref> The patient is kept on ventilator support until the organs have been surgically removed. If the patient has indicated in an [[advance health care directive]] that they do not wish to receive [[mechanical ventilation]] or has specified a [[do-not-resuscitate]] (DNR) order and the patient has also indicated that they wish to donate their organs, some vital organs such as the heart and lungs may not be able to be recovered.<ref>{{cite web|title=Frequently Asked Questions About Donation|url=http://health.mo.gov/living/organdonor/faq.php|quote=DNR will be honored. You can still be a tissue donor.}}</ref>

==Demographics==

=== United States ===
Brain death is responsible for 2% of all adult and 5% of pediatric in-hospital deaths in the United States.<ref name="Greer">{{cite journal |last1=Greer |first1=David M. |title=Determination of Brain Death |journal=New England Journal of Medicine |date=30 December 2021 |volume=385 |issue=27 |pages=2554–2561 |doi=10.1056/NEJMcp2025326|pmid=34965339 |s2cid=245566906 }}</ref> In a nationwide survey of [[pediatric intensive care unit]]s (PICU) in the United States in 2019; there were more than 3,000 pediatric brain deaths out of a total of more than 15,344 children who died in PICUs. According to a national study, "brain death evaluations are performed infrequently, even in large PICUs."<ref>{{cite journal|last1=Kirschen|first1=Matthew P.|url= |title=Epidemiology of Brain Death in Pediatric Intensive Care Units in the United States|last2=Francoeur|first2=Conall|last3=Murphy|first3=Marie|last4=Traynor|first4=Danielle|last5=Zhang|first5=Bingqing|last6=Mensinger|first6=Janell L.|last7=Ichord|first7=Rebecca|last8=Topjian|first8=Alexis|last9=Berg|first9=Robert A.|date=May 2019|journal=JAMA Pediatr|volume=173|pages=469–476|doi=10.1001/jamapediatrics.2019.0249|issn=2168-6203|oclc=8553840562|pmid=30882855|issue=5|pmc=6503509|last11=Morrison|first11=Wynne|first10=Akira|last10=Nishisaki}}</ref>

==See also==
{{Portal|Medicine}}
{{col div|colwidth=25em}}
* [[Brainstem death]]
* [[Clinical death]]
* [[Consciousness after death]]
* [[Death]]
* [[Persistent vegetative state]]
* [[Information-theoretic death]]
* [[Klaus Schäfer (catholic theologian)|Klaus Schäfer]]
{{colend}}

==References==
{{Reflist}}

== External links ==
{{Medical resources
| DiseasesDB      = 1572
| ICD10           =
| ICD9            = {{ICD9|348.82}}
| ICDO            =
| OMIM            =
| MedlinePlus     =
| eMedicineSubj   =
| eMedicineTopic  =
| MeshID          = D001926
| ICD10CM         = {{ICD10CM|G93.82}}
}}
{{disorders of consciousness}}
{{Death}}

{{Authority control}}

{{DEFAULTSORT:Brain Death}}
[[Category:Medical aspects of death]]
[[Category:Anatomical pathology]]
[[Category:Brain]]