Brain Failure and Brain Death

2018 ◽  
Author(s):  
Sharven Taghavi ◽  
Ali Salim
Keyword(s):  
Central Nervous System ◽  
Nervous System ◽  
Brain Death ◽  
Organ Donation ◽  
Wide Spectrum ◽  
Altered Level ◽  
Level Of Consciousness ◽  
The Central Nervous System ◽  
Brain Failure ◽  
Definition Of

Brain failure consists of a wide spectrum of central nervous system pathologies with many different neurologic manifestations. The causes of brain failure include several disease processes that result in decreased supply of blood and oxygen to the brain or metabolic derangements that affect the central nervous system. Brain failure usually results in some altered level of consciousness. Brain failure and brain death result in several pathophysiologic changes. The definition of brain death is controversial and evolving. However, clear guidelines to determine brain death have been established. These guidelines state that three cardinal findings be present to establish brain death: (1) coma or unresponsiveness, (2) absence of brainstem reflexes, and (3) apnea. Several clinical parameters must be met when these findings are made. Adjunctive studies such as four-vessel cerebral angiography, electroencephalography, and nuclear brain scintigraphy can help make a diagnosis of brain death. When brain death is established, suitability for organ transplantation should be evaluated. After obtaining consent, potential organ donation should be optimized for possible donation. This review contains 2 figures, 3 tables, and 69 references. Key Words: brain failure, brain death, consciousness, coma, death, delirium, organ donation

Brain Failure and Brain Death

2018 ◽  
Author(s):  
Sharven Taghavi ◽  
Ali Salim
Keyword(s):  
Central Nervous System ◽  
Nervous System ◽  
Brain Death ◽  
Organ Donation ◽  
Wide Spectrum ◽  
Altered Level ◽  
Level Of Consciousness ◽  
The Central Nervous System ◽  
Brain Failure ◽  
Definition Of

Brain failure consists of a wide spectrum of central nervous system pathologies with many different neurologic manifestations. The causes of brain failure include several disease processes that result in decreased supply of blood and oxygen to the brain or metabolic derangements that affect the central nervous system. Brain failure usually results in some altered level of consciousness. Brain failure and brain death result in several pathophysiologic changes. The definition of brain death is controversial and evolving. However, clear guidelines to determine brain death have been established. These guidelines state that three cardinal findings be present to establish brain death: (1) coma or unresponsiveness, (2) absence of brainstem reflexes, and (3) apnea. Several clinical parameters must be met when these findings are made. Adjunctive studies such as four-vessel cerebral angiography, electroencephalography, and nuclear brain scintigraphy can help make a diagnosis of brain death. When brain death is established, suitability for organ transplantation should be evaluated. After obtaining consent, potential organ donation should be optimized for possible donation. This review contains 2 figures, 3 tables, and 69 references. Key Words: brain failure, brain death, consciousness, coma, death, delirium, organ donation

Brain Failure and Brain Death

2018 ◽  
Author(s):  
Sharven Taghavi ◽  
Ali Salim
Keyword(s):  
Central Nervous System ◽  
Nervous System ◽  
Brain Death ◽  
Organ Donation ◽  
Wide Spectrum ◽  
Altered Level ◽  
Level Of Consciousness ◽  
The Central Nervous System ◽  
Brain Failure ◽  
Definition Of

Brain failure consists of a wide spectrum of central nervous system pathologies with many different neurologic manifestations. The causes of brain failure include several disease processes that result in decreased supply of blood and oxygen to the brain or metabolic derangements that affect the central nervous system. Brain failure usually results in some altered level of consciousness. Brain failure and brain death result in several pathophysiologic changes. The definition of brain death is controversial and evolving. However, clear guidelines to determine brain death have been established. These guidelines state that three cardinal findings be present to establish brain death: (1) coma or unresponsiveness, (2) absence of brainstem reflexes, and (3) apnea. Several clinical parameters must be met when these findings are made. Adjunctive studies such as four-vessel cerebral angiography, electroencephalography, and nuclear brain scintigraphy can help make a diagnosis of brain death. When brain death is established, suitability for organ transplantation should be evaluated. After obtaining consent, potential organ donation should be optimized for possible donation. This review contains 2 figures, 3 tables, and 69 references. Key Words: brain failure, brain death, consciousness, coma, death, delirium, organ donation

Brain Failure and Brain Death

2018 ◽  
Author(s):  
Sharven Taghavi ◽  
Ali Salim
Keyword(s):  
Central Nervous System ◽  
Nervous System ◽  
Brain Death ◽  
Organ Donation ◽  
Wide Spectrum ◽  
Altered Level ◽  
Level Of Consciousness ◽  
The Central Nervous System ◽  
Brain Failure ◽  
Definition Of

Brain failure consists of a wide spectrum of central nervous system pathologies with many different neurologic manifestations. The causes of brain failure include several disease processes that result in decreased supply of blood and oxygen to the brain or metabolic derangements that affect the central nervous system. Brain failure usually results in some altered level of consciousness. Brain failure and brain death result in several pathophysiologic changes. The definition of brain death is controversial and evolving. However, clear guidelines to determine brain death have been established. These guidelines state that three cardinal findings be present to establish brain death: (1) coma or unresponsiveness, (2) absence of brainstem reflexes, and (3) apnea. Several clinical parameters must be met when these findings are made. Adjunctive studies such as four-vessel cerebral angiography, electroencephalography, and nuclear brain scintigraphy can help make a diagnosis of brain death. When brain death is established, suitability for organ transplantation should be evaluated. After obtaining consent, potential organ donation should be optimized for possible donation. This review contains 2 figures, 3 tables, and 69 references. Key Words: brain failure, brain death, consciousness, coma, death, delirium, organ donation

Infections of the CNS: Meningitis and Encephalitis (DRAFT)

2018 ◽  
Author(s):  
Tamara Kaplan ◽  
Tracey Milligan
Keyword(s):  
Central Nervous System ◽  
Nervous System ◽  
Herpes Simplex ◽  
Herpes Simplex Encephalitis ◽  
Altered Level ◽  
Limbic Structures ◽  
Temporal Lobes ◽  
Nuchal Rigidity ◽  
Level Of Consciousness ◽  
The Central Nervous System

The video in this chapter discusses infections of the central nervous system (CNS), meningitis including its symptoms (fever, headache, nuchal rigidity, altered level of consciousness), its causes (bacterial, fungal, viral, or aseptic), and how the CSF profile provides clues to the etiology. The chapter also discusses encephalitis, its symptoms (seizures, other focal neurologic symptoms). Patients with Herpes Simplex Encephalitis may show T2 hyperintensities in the anterior temporal lobes and limbic structures on MRI. CSF may show xanthochromia and positive PCR for HSV1 or HSV2.

scholarly journals Primary adipsia and severe hypernatremia in a Pit Bull dog

2022 ◽  
Vol 52 (2) ◽  
Author(s):  
Simone Marques Caramalac ◽  
Silvana Marques Caramalac ◽  
Gustavo Gomes de Oliveira ◽  
Alda Izabel de Souza ◽  
Mariana Isa Poci Palumbo ◽  
...  
Keyword(s):  
Central Nervous System ◽  
Nervous System ◽  
Structural Changes ◽  
Plasma Osmolality ◽  
Rare Condition ◽  
Activation Threshold ◽  
Altered Level ◽  
Level Of Consciousness ◽  
The Central Nervous System ◽  
Is Failure

ABSTRACT: Primary adipsia is a rare condition in which there is failure in the activation threshold of the hypothalamic osmoreceptors, leading to osmolality imbalance. Here, we reported the case of a Pit Bull dog with an altered level of consciousness (started after weaning) and adipsia. There was an increase in plasma osmolality (444 mOsm/kg), sodium (223.7 mg/dL), and chlorine (173 mg/dL) levels. Based on the suspicion of primary adipsia, water was administered via a nasogastric tube, with clinical improvement. The owner was instructed to supply water with food. Eight months after discharge, the dog returned with parvovirus and died. In the anatomopathological examination, no structural changes were observed in the central nervous system. To our knowledge, this is the first report of hypernatremia due to adipsia in a Pit Bull dog, showing that this is a differential diagnosis that should be considered in this breed.

scholarly journals Primary Angiitis of the Center Nervous System: A Clinical Challenge Diagnosed Postmortem

2017 ◽  
Vol 2017 ◽  
pp. 1-4 ◽  
Author(s):  
Bayan Al Share ◽  
Ali Zakaria ◽  
Evan Hiner ◽  
Ziyad Iskenderian ◽  
Nader Warra
Keyword(s):  
Central Nervous System ◽  
Nervous System ◽  
Clinical Symptoms ◽  
Wide Spectrum ◽  
Imaging Techniques ◽  
Systemic Vasculitis ◽  
Comfort Care ◽  
Systemic Involvement ◽  
Primary Angiitis ◽  
The Central Nervous System

Primary angiitis of the central nervous system (PACNS) is a rare vasculitis involving medium and small blood vessels of the brain, spinal cord, and meninges, without systemic involvement. The diffuse and patchy nature of its pathology is reflected by a wide spectrum of nonspecific clinical symptoms. Diagnosis is challenging due to lack of defined clinical criteria or specific imaging findings. Specific workup should be done only after exclusion of other etiologies, including infectious, neoplastic, toxic, and other vascular etiologies including systemic vasculitis. Given the fact that it is a patchy disease with 25% of the biopsies being falsely negative, treating physician should have a high index of suspicion despite negative initial neurovascular imaging and biopsy results. Once diagnosed, early treatment with immunosuppressive therapy is essential to avoid permanent neurologic damage. Herein, we are reporting a case of 66-year-old female patient who presented with insidious onset right-sided frontal headache. Her hospital course progressively worsened and family decision based on her wishes was to refer her to hospice and comfort care. Despite an extensive workup with advanced imaging techniques, no diagnosis was established until postmortem autopsy and histopathology confirmed primary angiitis of the central nervous system.

scholarly journals Signs and Symptoms of Central Nervous System Involvement and Their Pathogenesis in COVID-19 According to The Clinical Data (Review)

2021 ◽  
Vol 17 (3) ◽  
pp. 65-77
Author(s):  
N. V. Tsygan ◽  
A. P. Trashkov ◽  
A. V. Ryabtsev ◽  
V. A. Yakovleva ◽  
A. L. Konevega ◽  
...  
Keyword(s):  
Central Nervous System ◽  
Nervous System ◽  
Clinical Data ◽  
Nervous Tissue ◽  
Central Nervous System Involvement ◽  
Signs And Symptoms ◽  
Neurological Manifestations ◽  
Altered Level ◽  
System Involvement ◽  
The Central Nervous System

Detailed clinical assessment of the central nervous system involvement in SARS-CoV-2 infection is relevant due to the low specificity of neurological manifestations, the complexity of evaluation of patient complaints, reduced awareness of the existing spectrum of neurological manifestations of COVID-19, as well as low yield of the neurological imaging.The aim. To reveal the patterns of central nervous system involvement in COVID-19 and its pathogenesis based on clinical data.Among more than 200 primary literature sources from various databases (Scopus, Web of Science, RSCI, etc.), 80 sources were selected for evaluation, of them 72 were published in the recent years (2016-2020). The criteria for exclusion of sources were low relevance and outdated information.The clinical manifestations of central nervous system involvement in COVID-19 include smell (5-98% of cases) and taste disorders (6-89%), dysphonia (28%), dysphagia (19%), consciousness disorders (3-53%), headache (0-70%), dizziness (0-20%), and, in less than 3% of cases, visual impairment, hearing impairment, ataxia, seizures, stroke. Analysis of the literature data revealed the following significant mechanisms of the effects of highly contagious coronaviruses (including SARS-CoV-2) on the central nervous system: neurodegeneration (including cytokine- induced); cerebral thrombosis and thromboembolism; damage to the neurovascular unit; immune-mediated damage of nervous tissue, resulting in infection and allergy-induced demyelination.The neurological signs and symptoms seen in COVID-19 such as headache, dizziness, impaired smell and taste, altered level of consciousness, bulbar disorders (dysphagia, dysphonia) have been examined. Accordingly, we discussed the possible routes of SARS-CoV-2 entry into the central nervous system and the mechanisms of nervous tissue damage.Based on the literature analysis, a high frequency and variability of central nervous system manifestations of COVID-19 were revealed, and an important role of vascular brain damage and neurodegeneration in the pathogenesis of COVID-19 was highlighted.

scholarly journals Modern aspects of neuropathogenesis and neurological manifestations of COVID-19

2021 ◽  
Vol 17 (2) ◽  
pp. 6-15
Author(s):  
L.A. Dziak ◽  
O.S. Tsurkalenko ◽  
K.V. Chekha ◽  
V.M. Suk
Keyword(s):  
Central Nervous System ◽  
Nervous System ◽  
Psychiatric Symptoms ◽  
Clinical Manifestations ◽  
The Body ◽  
Altered Level ◽  
Wide Range ◽  
The Central Nervous System ◽  
The Brain

Coronavirus infection is a systemic pathology resulting in impairment of the nervous system. The involvement of the central nervous system in COVID-19 is diverse by clinical manifestations and main mechanisms. The mechanisms of interrelations between SARS-CoV-2 and the nervous system include a direct virus-induced lesion of the central nervous system, inflammatory-mediated impairment, thrombus burden, and impairment caused by hypoxia and homeostasis. Due to the multi-factor mechanisms (viral, immune, hypoxic, hypercoagulation), the SARS-CoV-2 infection can cause a wide range of neurological disorders involving both the central and peripheral nervous system and end organs. Dizziness, headache, altered level of consciousness, acute cerebrovascular diseases, hypogeusia, hyposmia, peripheral neuropathies, sleep disorders, delirium, neuralgia, myalgia are the most common signs. The structural and functional changes in various organs and systems and many neurological symptoms are determined to persist after COVID-19. Regardless of the numerous clinical reports about the neurological and psychiatric symptoms of COVID-19 as before it is difficult to determine if they are associated with the direct or indirect impact of viral infection or they are secondary to hypoxia, sepsis, cytokine reaction, and multiple organ failure. Penetrated the brain, COVID-19 can impact the other organs and systems and the body in general. Given the mechanisms of impairment, the survivors after COVID-19 with the infection penetrated the brain are more susceptible to more serious diseases such as Parkinson’s disease, cognitive decline, multiple sclerosis, and other autoimmune diseases. Given the multi-factor pathogenesis of COVID-19 resulting in long-term persistence of the clinical symptoms due to impaired neuroplasticity and neurogenesis followed by cholinergic deficiency, the usage of Neuroxon® 1000 mg a day with twice-day dosing for 30 days. Also, a long-term follow-up and control over the COVID-19 patients are recommended for the prophylaxis, timely determination, and correction of long-term complications.

scholarly journals Metabolic Syndrome: Is It Time to Add the Central Nervous System?

Nutrients ◽  
2021 ◽  
Vol 13 (7) ◽  
pp. 2254
Author(s):  
Milagros Rojas ◽  
Mervin Chávez-Castillo ◽  
Daniela Pirela ◽  
Heliana Parra ◽  
Manuel Nava ◽  
...  
Keyword(s):  
Metabolic Syndrome ◽  
Central Nervous System ◽  
Nervous System ◽  
Classification Systems ◽  
Cns Involvement ◽  
Bidirectional Relationship ◽  
The Central Nervous System ◽  
The Subject ◽  
Points Of View ◽  
Definition Of

Metabolic syndrome (MS) is a set of cardio-metabolic risk factors that includes central obesity, hyperglycemia, hypertension, and dyslipidemias. The syndrome affects 25% of adults worldwide. The definition of MS has evolved over the last 80 years, with various classification systems and criteria, whose limitations and benefits are currently the subject of some controversy. Likewise, hypotheses regarding the etiology of MS add more confusion from clinical and epidemiological points of view. The leading suggestion for the pathophysiology of MS is insulin resistance (IR). IR can affect multiple tissues and organs, from the classic “triumvirate” (myocyte, adipocyte, and hepatocyte) to possible effects on organs considered more recently, such as the central nervous system (CNS). Mild cognitive impairment (MCI) and Alzheimer’s disease (AD) may be clinical expressions of CNS involvement. However, the association between MCI and MS is not understood. The bidirectional relationship that seems to exist between these factors raises the questions of which phenomenon occurs first and whether MCI can be a precursor of MS. This review explores shared pathophysiological mechanisms between MCI and MS and establishes a hypothesis of a possible MCI role in the development of IR and the appearance of MS.

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