ACS Stroke Sepsis

Cincinnati Stroke Program

Clinical Criteria for Brain Death in Children and Adults

  1. Coma with Temperature > 36.5C, Systolic BP >90mmHg
  2. Absence of Motor Responses
    *Painful stimuli above clavicles
    *Cold water calorics (CNIII, VI, VIII)
  3. Absence of pupillary responses to light, pupils round or oval at midposition and dilated to 4-6mm (CNII & III)
  4. Absent corneal reflexes (CNV & VII)
  5. Absent gag reflex (CNXI & XII)
  6. Absent cough in response to tracheal suctioning (CNIX & X)
  7. Absence of sucking/rooting reflex
  8. Apnea with PaCO2 of 60mmHg or 20mmHg above baseline (COPD patients)
  9. Interval between two evaluations
    • Term to 2mo: 48 hrs
    • >2m/o-1yo: 24 hrs
    • 1-18yo: 12 hrs
    • >=18 yo: Interval is optional
  10. Confirmatory Tests:
    • Term to 2mo: 2 confirmatory tests (EEG, Cerebral Angiography, Transcranial Dopplers, Cerebral Scintigraphy)
    • >2m/o-1yo: 1 confirmatory test
    • >1 yo: optional

References

Wijdicks, EFM. The Diagnosis of Brain Death. NEJM 2001; 344 (16) 1215-1221.