Brain Death Determination
When the brain has a lack of oxygen, even for a few minutes, it could lead to loss of brain functions such as a gradual loss level of consciousness or a complete loss of consciousness causing the person to slip into a coma. In the most profound cases, irreversible brain damage and death occurs. Oxygen deficiency can by caused by many things, such as; a brain injury, fall from height, traffic accidents, heart failure, stroke or some neurological disease. That may cause irreversible loss of the brain cells performance. The medical term for insufficient oxygenation to the brain is cerebral anoxia. Historically, before recent technology the scientists defined death only when the heartbeat and breathing stopped. Afterward, the idea of brain death was announced in 1959 by French neurologists’ Mollaret and Goulon. They determined this state as “beyond coma” (Döşemeci et al., 2004). Then after around ten years, within the medical community the development of many types of equipment became available which aided in increasing the longevity of individuals with serious injuries to the brain. Some examples of these devices are ventilators to maintain respiration and heart monitors. These innovations in medicine made the concept of brain death clearer by closely showing the relationship between the respirations or heartbeat and brain. These innovations in the medical field guided the Harvard Medical School Committee to clarify that idea in 1968 (Sass, 2014). After that, it was medically defined as permanent loss of all brain functions, including cerebrum and brain stem due to total death of brain neurons that is caused by decrease of blood flow and oxygenation into the brain (ibid). This essay will discuss the main brain regions that have immediate cause of brain death and their functions, including the required tests of these regions, both clinical and confirmatory, for instance, the Electroencephalogram. The brain carries two major parts, cerebrum and brain stem. When they have any cause of damaged that might be a final result in brain death. Each one has primary roles in a person’s life, because they are responsible for the main operations in human survival, especially the regulation of cardiac and respiratory functions. The cerebrum is the largest part of the brain and divided into two hemispheres (Afifi & Bergman, 1998). There are main functions for the brain cerebrum without them no human can live. It is important to be concerned with functional specialization of different regions of the cerebrum to guide the treatment of the physician and assists them in making the right diagnosis. The cerebrum has a large primary sensory area, which is responsible for general sensation, for example, smell, vision, and hearing. The motor area is responsible for controlling the skeletal muscles, and the association area of the cortex has operations similar to the sensory areas but more complicated such as behavior, communication and intellect (ibid). Secondly, the brain stem is located in the posterior division of the brain and connected to the spinal cord. Beside that it includes three significant parts; medulla oblongata, pons and midbrain. Each one controls principal performance and it is the pathway of sending and receiving sensory information signals from the body to the brain. It has other important functions that have a major affect on a person such as regulation of the respiratory system, consciousness, alertness and awareness (Kiernan & Barr, 2009). In general, both cerebrum and brain stem damage may end a person’s life because they contain all the regulation centers for all of the most critical functions that are needed to sustain life. There are many criteria to diagnose brain death. Each country has their organization, but there are general rules and guidelines in determining brain death for patients worldwide. There are important tools to consider when deciding whether the patient is dead or not, before...
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