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Electrocerebral Silence Associated With Adequate Spontaneous Ventilation in a Case of Fat EmbolismA Clinical and Medicolegal Dilemma
Azmy R. Boutros, MD;
Charles E. Henry, PhD
Arch Neurol. 1982;39(5):314-316.
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| Since this article does not have an abstract, we have provided the first 150 words of the full text PDF and any section headings. |
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The recommended1-4 criteria for diagnosing cerebral death are electrocerebral silence (ECS) in an EEG performed in conformance with rigorous requirements outlined by the American Electroencephalographic Society5 and supportive clinical correlates, including absence of spontaneous ventilation and other spontaneous movements and total absence of brainstem-mediated reflexes. The patient must not be hypothermic or have drug-induced central depression.
A meticulous survey of 1,665 patients reported to have ECS found recovery in only three patients who were suffering from drug overdose.2 Two other patients with ECS maintained or regained effective spontaneous ventilation, coordinated movements, and reflex activities at the brainstem and spinal cord levels.6 Both survived for five months. Presumably, the EEG conformed to the criteria mentioned above. To our knowledge, there are no other well-documented reports of unambiguous ECS in adult patients who maintained spontaneous ventilation as the only brainstem function for any length of time.
This report
. . . [Full Text PDF of this Article]
Author Affiliations
From the Departments of Anesthesiology (Surgical Intensive Care Unit) (Dr Boutros) and Neurology (Dr Henry), Cleveland Clinic Foundation. Dr Henry is now with the Department of Neurology, Medical College of Virginia, Richmond.
Footnotes
Accepted for publication July 20, 1981.
Reprint requests to Division of Anesthesiology, The Cleveland Clinic, 9500 Euclid Ave, Cleveland, OH 44106 (Dr Boutros).
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