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Brain dead: Clinical and neuropathological aspects

Abstract:

Brain death (BD) is caused by a catastrophic injury leading to irreversible coma, absent brainstem reflexes and apnea. Recent publications of autopsy studies in brain-dead patients have concluded that due to organ transplant protocols, the time to brain fixation has been abbreviated and consequently, no distinguishing BD neuropathologic features can be described. Nonetheless, as autopsies allow the most complete description of the disease leading to BD, the objective of this paper is to describe the clinical and pathologic features in a series of 26 brain-dead patients, from a tertiary hospital of Havana, Cuba, from 2006 to 2008. We concluded that it is not possible to find any distinctive neuropathologic feature in BD. Autopsy studies remain the best method to confirm the direct cause of death, leading to an irreversible destruction of the brain. Hence, we recommend performing neuropathologic and clinical studies in brain-dead patients.