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What is it?
Brain death is a severe and irreversible loss of consciousness in which the brain completely loses all functions. May also be called irreversible coma.
Who gets it?
Brain death can be present at birth, or can be caused by outside factors during childhood.
What causes it?
Brain death is caused by any disease or injury that creates swelling in the brain. Some common causes of brain death in children include shaken baby syndrome, brain tumor, traumatic head injury, and stroke.
What are the symptoms?
While the heart still beats, the loss of brain function means a child who is brain dead cannot breathe without the help of a respirator. He or she will have no physical response to pain or pupil response to light. There may be some reflexive movement if the spinal cord still functions.
How is it diagnosed?
Every state has a legal definition of brain death that healthcare professionals use to determine when to pronounce a patient brain dead. However, there are some medical conditions, such as hypothermia, sedative-type drugs, and poisoning, that can create the appearance of brain death and must be ruled out before a definite diagnosis is made. With children, doctors generally look for a complete loss of consciousness combined with absence of speech, the inability to breathe without a respirator, and loss of muscle tone. Doctors also look for a complete loss of functions normally controlled by the brainstem. These include the gag reflex, spontaneous eye movement, and movement of the facial muscles. Blood pressure and body temperature should be normal. A Doppler ultrasound or electroencephalogram is used to determine whether there is any electrical activity of the brain. These tests are performed at regular intervals over a period of at least 12 to 24 hours (48 hours in infants under two months old) to rule out any reversible causes of the child's symptoms.
What is the treatment?
There is no treatment to reverse brain death. While the child can be kept on a respirator to maintain breathing, death usually occurs very quickly if the respirator is removed.
Preventative measures can be accomplished by having a child wear a helmet when riding a bike or other activities that could result in a fall with a head injury.
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