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Brain Death and the Persistent Vegetative State: Similarities and Contrasts

Published online by Cambridge University Press:  18 September 2015

Bryan Young ,
Warren Blume  and
Abbyann Lynch
Bryan Young*
Affiliation:
Department of Clinical Neurological Sciences, University of Western Ontario, London
Warren Blume
Affiliation:
Department of Clinical Neurological Sciences, University of Western Ontario, London
Abbyann Lynch
Affiliation:
Westminster Institute for Ethics and Human Values, University of Western Ontario, London
*
Department of Clinical Neurological Sciences, Victoria Hospital, 375 South St., London, Ontario, Canada N6A 4G5
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Abstract:

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Brain death and the persistent vegetative state (PVS) share the following features: 1.) There is death of neurons in the brain; 2.) Both require an etiology which is capable of causing neuronal death. 3.) The potential for cognition is totally and permanently lost; 4.) Intensive medical support is usually withdrawn. In contrast, the diagnosis of brain death depends on death of the brainstem, while PVS implies permanent and total loss of forebrain function. While brainstem death can be diagnosed clinically, accurate prognosis in PVS requires additional investigation. Thus far, the EEG is the most specific test of neuronal function in the cerebral cortex. Brain death is equivalent to death, while PVS is not; management of the latter is more complex because of medical, social, ethical and legal factors.

Résumé:

RÉSUMÉ:

Les éléments suivants sont communs à la mort cérébrale et à l'état végétatif persistant (PVS): 1) Il y a mort neuronale dans le cerveau. 2) Les deux nécessitent une étiologie capable de causer la mort de neurones. 3) Le potentiel cognitif (individualité) est totalement et irrémédiablement perdu. 4) Les mesures d'appui médical intensives sont habituellement supprimées. Par contre, le diagnostic de mort cérébrale dépend de la mort du tronc cérébral, alors que le PVS implique une perte totale et permanente de fonction du prosencéphale; la mort du tronc cérébral peut être diagnostiquée cliniquement, tandis que pour le PVS, un pronostic exact nécessite une investigation. À date, l'EEG est l'épreuve la plus spécifique de la fonction neuronale du cortex cérébral. La mort cérébrale est équivalente à la mort, alors que le PVS ne l'est pas; la conduite à tenir dans le second cas est plus complexe à cause de facteurs médicaux, sociaux, éthiques et légaux.

Type
Editorial Review
Information
Canadian Journal of Neurological Sciences , Volume 16 , Issue 4 , November 1989 , pp. 388 - 393
Copyright
Copyright © Canadian Neurological Sciences Federation 1989

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