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Diagnosis of brain death

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https://www.readbyqxmd.com/read/29232618/pediatric-medicolegal-autopsy-in-france-a-forensic-histopathological-approach
#1
Clémence Delteil, Lucile Tuchtan, Julia Torrents, Caroline Capuani, Marie-Dominique Piercecchi-Marti
The aim of postmortem medicolegal examination in pediatric death is primarily to establish the circumstances and causes of death and to exclude child abuse. In France, pediatric death is systematically documented by medicolegal or medical autopsy. In case of medicolegal autopsy, the complementary examinations, requested and financed by justice, are rarely limited to a histopathological examination. However in medical autopsies other tools are available to the pathologist as toxicology, biochemistry and molecular biology...
December 5, 2017: Journal of Forensic and Legal Medicine
https://www.readbyqxmd.com/read/29229509/diagnosis-of-congenital-abnormalities-with-post-mortem-ultrasound-in-perinatal-death
#2
L Tuchtan, E Lesieur, C Bartoli, C Delteil, L Sarda-Quarello, J Torrents, S Sigaudy, M-D Piercecchi, G Gorincour
PURPOSE: To determine the sensitivity and specificity of post-mortem ultrasound in the diagnosis of major congenital abnormalities of fetuses using conventional autopsy as the standard of reference. MATERIAL AND METHODS: All fetuses coming from terminations of pregnancy or intrauterine fetal deaths in a single institution were included. A total of 75 fetuses were included during the study period. The results of post-mortem ultrasound examinations were compared to those of conventional autopsy that served as standard of reference...
December 8, 2017: Diagnostic and Interventional Imaging
https://www.readbyqxmd.com/read/29226520/a-novel-homozygous-slc25a1-mutation-with-impaired-mitochondrial-complex-v-possible-phenotypic-expansion
#3
Idan Cohen, Orna Staretz-Chacham, Ohad Wormser, Yonatan Perez, Ann Saada, Rotem Kadir, Ohad S Birk
SLC25A1 mutations are associated with combined D,L-2-hydroxyglutaric aciduria (DL- 2HGA; OMIM #615182), characterized by muscular hypotonia, severe neurodevelopmental dysfunction and intractable seizures. SLC25A1 encodes the mitochondrial citrate carrier (CIC), which mediates efflux of the mitochondrial tricarboxylic acid (TCA) cycle intermediates citrate and isocitrate in exchange for cytosolic malate. Only a single family with an SLC25A1 mutation has been described in which mitochondrial respiratory chain dysfunction was documented, specifically in complex IV...
December 11, 2017: American Journal of Medical Genetics. Part A
https://www.readbyqxmd.com/read/29201852/chronic-brain-dead-patients-who-exhibit-lazarus-sign
#4
Ji Won Moon, Dong Keun Hyun
Lazarus sign, a complex reflex movement of the upper limbs after brain death, is a rare occurrence. We report two patients who showed a Lazarus sign following a diagnosis of brain death. It has been accepted that cardiac arrest usually occurs within 1 week after brain death; however, the two patients described herein survived for over 100 days after brain death was diagnosed. This report is intended to examine the relationship between the Lazarus sign and long-term survival after brain death, as well as to share our rare experience...
October 2017: Korean Journal of Neurotrauma
https://www.readbyqxmd.com/read/29190573/common-comorbidities-and-survival-in-ms-risk-for-stroke-type-1-diabetes-and-infections
#5
A Murtonen, S Kurki, K Hänninen, M Soilu-Hänninen, M-L Sumelahti
BACKGROUND: Survival in MS has increased during the era of disease modifying therapies, but life expectancy in MS patients is still reduced by several years. Increased risk for common comorbidities related to brain health, such as risk for circulatory diseases have been reported in MS and could affect survival. In this paper, we studied age- and gender adjusted risks for circulatory diseases and related disorders, and their impact on overall MS survival in population of Southwest Finland...
November 13, 2017: Multiple Sclerosis and related Disorders
https://www.readbyqxmd.com/read/29183088/-organ-donation-in-victims-of-non-traumatic-out-of-hospital-cardiac-arrest
#6
Martin Christ, Katharina Isabel von Auenmüller, Michael Brand, Verena Gessner, Martin Grett, Nedall Zalloum, Wolfgang Dierschke, Hans-Joachim Trappe
Introduction The out-of-hospital cardiac-arrest (OHCA) is one of the leading causes of death. However, although previous studies showed the possibility to transplant organs from resuscitated donors, organ donation following OHCA remains seldom. We therefore initiated this study to investigate the current percentage of organ donation in victims of OHCA in a german university hospital. Material and Methods We analyzed data from all victims of OHCA who were admitted to our hospital between January 1st 2008 and May 31st 2017...
November 28, 2017: Deutsche Medizinische Wochenschrift
https://www.readbyqxmd.com/read/29181510/neurologic-phenotypes-associated-with-mutations-in-rtn4ip1-opa10-in-children-and-young-adults
#7
Majida Charif, Alessia Nasca, Kyle Thompson, Sylvie Gerber, Christine Makowski, Neda Mazaheri, Céline Bris, David Goudenège, Andrea Legati, Reza Marrofian, Gholamreza Shariati, Eleonora Lamantea, Sila Hopton, Anna Ardissone, Isabella Moroni, Melania Giannotta, Corinna Siegel, Tim M Strom, Holger Prokisch, Catherine Vignal-Clermont, Sabine Derrien, Xavier Zanlonghi, Josseline Kaplan, Christian P Hamel, Stephanie Leruez, Vincent Procaccio, Dominique Bonneau, Pascal Reynier, Frances E White, Steven A Hardy, Inês A Barbosa, Michael A Simpson, Roshni Vara, Yaumara Perdomo Trujillo, Hamind Galehdari, Charu Deshpande, Tobias B Haack, Jean-Michel Rozet, Robert W Taylor, Daniele Ghezzi, Patrizia Amati-Bonneau, Guy Lenaers
Importance: Neurologic disorders with isolated symptoms or complex syndromes are relatively frequent among mitochondrial inherited diseases. Recessive RTN4IP1 gene mutations have been shown to cause isolated and syndromic optic neuropathies. Objective: To define the spectrum of clinical phenotypes associated with mutations in RTN4IP1 encoding a mitochondrial quinone oxidoreductase. Design, Setting, and Participants: This study involved 12 individuals from 11 families with severe central nervous system diseases and optic atrophy...
November 27, 2017: JAMA Neurology
https://www.readbyqxmd.com/read/29177397/-not-everything-is-zika-congenital-toxoplasmosis-still-prevalent-in-colombia
#8
Jorge L Alvarado-Socarras, Keyla Meneses-Silvera, Andrea Carolina Zarate-Vergara, Carlos Guerrero-Gomez, Alfonso J Rodriguez-Morales
Congenital toxoplasmosis continues to be a public health threat. Even existing guidelines, publicly known, its implementation and lack of appropriate interpretation of serological tests in pregnancy is often observed. This leds to failure in opportunities for positive and known interventions to decrease the fetal risk due to Toxoplasma gondii infection. We reported herein a case series, with variable neurological and systemic compromise (respiratory distress, hepatosplenomegaly, enterocolitis, brain calcifications, thrombocytopenia, ascites, shock), even fatal, calling for awareness about the fact that despite the Zika epidemics in 2015-2016 in Brazil, Colombia and other countries, precisely toxoplasmosis, is a differential diagnosis still prevalent in these territories, that can leds to severe consequences, with neurological disability and risk of ocular damage, even lately...
April 2017: Revista Peruana de Medicina Experimental y Salud Pública
https://www.readbyqxmd.com/read/29173061/targeted-sequencing-of-malignant-supratentorial-pediatric-brain-tumors-demonstrates-a-high-frequency-of-clinically-relevant-mutations
#9
Bonnie L Cole, Colin C Pritchard, Maia Anderson, Sarah Es Leary
Pediatric brain tumors cause more deaths than any other childhood malignancy, and the identification of potentially actionable genomic alterations in this rare heterogeneous group of tumors may improve treatment and outcome. The genetic landscape of common posterior fossa tumors has been described in the past several years, yet the classification of malignant pediatric supratentorial tumors remains controversial. Next-generation sequencing is a promising tool to evaluate multiple genes concurrently. The clinical utility of next-generation sequencing has not been proven in pediatric brain tumors...
January 1, 2017: Pediatric and Developmental Pathology
https://www.readbyqxmd.com/read/29157218/brain-medical-image-diagnosis-based-on-corners-with-importance-values
#10
Linlin Gao, Haiwei Pan, Qing Li, Xiaoqin Xie, Zhiqiang Zhang, Jinming Han, Xiao Zhai
BACKGROUND: Brain disorders are one of the top causes of human death. Generally, neurologists analyze brain medical images for diagnosis. In the image analysis field, corners are one of the most important features, which makes corner detection and matching studies essential. However, existing corner detection studies do not consider the domain information of brain. This leads to many useless corners and the loss of significant information. Regarding corner matching, the uncertainty and structure of brain are not employed in existing methods...
November 21, 2017: BMC Bioinformatics
https://www.readbyqxmd.com/read/29151166/t2-weighted-images-are-superior-to-other-mr-image-types-for-the-determination-of-diffuse-intrinsic-pontine-glioma-intratumoral-heterogeneity
#11
Stephen Harward, S Harrison Farber, Michael Malinzak, Oren Becher, Eric M Thompson
PURPOSE: Diffuse intrinsic pontine glioma (DIPG) remains the main cause of death in children with brain tumors. Given the inefficacy of numerous peripherally delivered agents to treat DIPG, convection enhanced delivery (CED) of therapeutic agents is a promising treatment modality. The purpose of this study was to determine which MR imaging type provides the best discrimination of intratumoral heterogeneity to guide future stereotactic implantation of CED catheters into the most cellular tumor regions...
November 18, 2017: Child's Nervous System: ChNS: Official Journal of the International Society for Pediatric Neurosurgery
https://www.readbyqxmd.com/read/29150710/computed-tomography-perfusion-is-a%C3%A2-useful-adjunct-to-computed-tomography-angiography-in-the-diagnosis-of-brain-death
#12
M Sawicki, J Sołek-Pastuszka, K Chamier-Ciemińska, A Walecka, J Walecki, R Bohatyrewicz
BACKGROUND: In the diagnosis of brain death (BD), computed tomography angiography (CTA) results in some cases show intracranial filling, leading to diagnostic confusion. Because cerebral circulatory arrest commences at the capillary level, we hypothesized that computed tomography perfusion (CTP) would be a more sensitive approach than CTA; therefore, the aim of the study was to compare the sensitivities of CTP and CTA in the diagnosis of BD. MATERIAL AND METHODS: Whole brain CTP was performed in patients in the intensive care unit diagnosed with BD and CTA was derived from CTP datasets...
November 17, 2017: Clinical Neuroradiology
https://www.readbyqxmd.com/read/29149396/a-survey-on-pediatric-brain-death-and-on-organ-transplantation-how-did-the-law-amendment-change-the-awareness-of-pediatric-healthcare-providers
#13
Takashi Araki, Hiroyuki Yokota, Koutaro Ichikawa
OBJECTIVES: In Japanese society taking a cautious attitude towards organ transplantation, we investigate how amendment of the Organ Transplant Law which legalized brain death (BD) determination criteria changed the awareness concerning BD and organ transplantation of pediatric healthcare providers. METHODS: The questionnaire survey adopted the bearer method and was sent to members of the Japanese Society of Emergency Pediatrics (JSEP). In both the surveys of 2008 and 2016, the same item "Questionnaire survey on BD and organ transplant" was disseminated...
October 2017: Child's Nervous System: ChNS: Official Journal of the International Society for Pediatric Neurosurgery
https://www.readbyqxmd.com/read/29147859/initial-psycho-oncological-counselling-in-neuro-oncology-analysis-of-topics-and-needs-of-brain-tumour-patients
#14
Stephanie Schipmann, Eric Suero Molina, Anna Frasch, Walter Stummer, Dorothee Wiewrodt
Diagnosis of a brain tumour is associated with a tremendous disruption of emotional, physical and social well-being. Due to the complexity of the disease and the affection of the central organ, the brain, brain tumour patients differ from other cancer patients. The purpose of this study was to evaluate the concerns and burdens presented by brain tumour patients during their initial psycho-oncological consultation. We performed a retrospective analysis of 53 patients with the diagnosis of either benign or malignant brain tumour, seeking counsel by a neurosurgeon specialised in psycho-oncology...
November 17, 2017: Journal of Neuro-oncology
https://www.readbyqxmd.com/read/29136240/postmortem-autopsy-confirmation-of-antemortem-f-18-fddnp-pet-scans-in-a-football-player-with-chronic-traumatic-encephalopathy
#15
Bennet Omalu, Gary W Small, Julian Bailes, Linda M Ercoli, David A Merrill, Koon-Pong Wong, Sung-Cheng Huang, Nagichettiar Satyamurthy, Jennifer L Hammers, John Lee, Robert P Fitzsimmons, Jorge R Barrio
Currently, only presumptive diagnosis of chronic traumatic encephalopathy (CTE) can be made in living patients. We present a modality that may be instrumental to the definitive diagnosis of CTE in living patients based on brain autopsy confirmation of [F-18]FDDNP-PET findings in an American football player with CTE. [F-18]FDDNP-PET imaging was performed 52 mo before the subject's death. Relative distribution volume parametric images and binding values were determined for cortical and subcortical regions of interest...
November 10, 2017: Neurosurgery
https://www.readbyqxmd.com/read/29132508/brain-death
#16
REVIEW
Mack Drake, Andrew Bernard, Eugene Hessel
Death determined by neurologic criteria, commonly referred to as "brain death," occurs when function of the entire brain ceases, including the brain stem. Diagnostic criteria for brain death are explicit but controversy exists regarding nuances of the evaluation and potential confounders of the examination. Hospitals and ICU teams should carefully consider which clinicians will perform brain death testing and should use standard processes, including checklists to prevent diagnostic errors. Proper diagnosis is essential because misdiagnosis can be catastrophic...
December 2017: Surgical Clinics of North America
https://www.readbyqxmd.com/read/29129151/false-positive-diagnosis-of-brain-death-following-the-pediatric-guidelines-case-report-and-discussion
#17
D Alan Shewmon
A 2-year-old boy with severe head trauma was diagnosed brain dead according to the 2011 Pediatric Guidelines. Computed tomographic (CT) scan showed massive cerebral edema with herniation. Intracranial pressures were extremely high, with cerebral perfusion pressures around 0 for several hours. An apnea test was initially contraindicated; later, one had to be terminated due to oxygen desaturation when the Pco2 had risen to 57.9 mm Hg. An electroencephalogram (EEG) was probably isoelectric but formally interpreted as equivocal...
December 2017: Journal of Child Neurology
https://www.readbyqxmd.com/read/29128780/apnea-testing-using-the-oxygen-insufflation-method-for-diagnosis-of-brain-death-may-compromise-pulmonary-function
#18
Joanna Sołek-Pastuszka, Marcin Sawicki, Waldemar Iwańczuk, Klaudyna Kojder, Wojciech Saucha, Zenon Czajkowski, Kornel Chełstowski, Romuald Bohatyrewicz
INTRODUCTION: The aim of our study was to compare the reliability and safety of the classical I-AT with the continuous positive airway pressure apnea test (CPAP-AT). MATERIAL AND METHODS: In the group of 48 patients (group O), an I-AT was performed at the end of BD diagnostic procedures, and approximately 1-1.5h later CPAP-AT with 100% FiO2 and CPAP of 10cm H2O, provided by ventilator in CPAP mode. After pre‑oxygenation with 100% FiO2 for 10min, the PaO2/FiO2 ratio was recorded prior to I-AT at time-point one (T1) and prior to CPAP-AT at time-point two (T2)...
October 28, 2017: Journal of Critical Care
https://www.readbyqxmd.com/read/29122497/further-delineation-of-the-phenotypic-spectrum-of%C3%A2-isca2-defect-a-report-of-ten-new-cases
#19
Majid Alfadhel, Marwan Nashabat, Muhammad Talal Alrifai, Hesham Alshaalan, Fuad Al Mutairi, Saif A Al-Shahrani, Barbara Plecko, Rawan Almass, Maysoon Alsagob, Faten B Almutairi, Ahmed Al-Rumayyan, Waleed Al-Twaijri, Mohammed Al-Owain, Robert W Taylor, Namik Kaya
Iron-Sulfur Cluster (ISC) biogenesis is a vital cellular process required to produce various ISC-containing proteins. These ISC proteins are responsible for essential functions such as glycine cleavage and the formation of lipoic acid, an essential cofactor of respiratory chain complexes. Defects in ISC biogenesis lead to multiple mitochondrial dysfunction syndromes including: ISCA2 with infantile onset leukodystrophy. Recently, a founder mutation, c.229G > A, p.Gly77Ser in ISCA2 was reported to cause Multiple Mitochondrial Dysfunction Syndrome type 4...
October 16, 2017: European Journal of Paediatric Neurology: EJPN
https://www.readbyqxmd.com/read/29120874/unusual-suicide-by-a-speargun-shot-through-the-mouth-a-case-report
#20
Youssef Nouma, Sami Krimi, Karama Regaieg
We report an unusual case of suicide committed with a speargun shot through the mouth, causing a penetrating brain injury. The special features of the present case are not only related to the method chosen for the purpose but also to the difficulties encountered in confirming the diagnosis. Although this type of suicide has been previously reported, this case is particularly interesting in terms of the shooting mechanism and manner of death. Because of the length of the weapon, which was apparently used and found at the scene, a suicidal manner of death first seemed unlikely and the possibility of a simulated suicide was raised...
November 9, 2017: American Journal of Forensic Medicine and Pathology
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