gms | German Medical Science

55. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie e. V. (DGNC)
1. Joint Meeting mit der Ungarischen Gesellschaft für Neurochirurgie

Deutsche Gesellschaft für Neurochirurgie (DGNC) e. V.

25. bis 28.04.2004, Köln

Brain death versus brainstem death: An international analysis of historic and actual criteria to diagnose death

Hirntod versus Hirnstammtod: ein internationaler Vergleich historischer und aktueller Todeskriterien

Meeting Abstract

Suche in Medline nach

  • corresponding author Johannes Kuchta - Neurochirurgische Universitätsklinik, Klinikum der Universität zu Köln, Köln

Deutsche Gesellschaft für Neurochirurgie. Ungarische Gesellschaft für Neurochirurgie. 55. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie e.V. (DGNC), 1. Joint Meeting mit der Ungarischen Gesellschaft für Neurochirurgie. Köln, 25.-28.04.2004. Düsseldorf, Köln: German Medical Science; 2004. DocDI.01.05

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Veröffentlicht: 23. April 2004

© 2004 Kuchta.
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The earliest references in the neurosurgical literature to states resembling what would today be called "brain death" go back to 1894, when Victor Horsley reported that patients with cerebral haemorrhage "die from respiratory and not from cardiac failure". Harvey Cushing noted 1902 that "a wide opening of the calvarium, may save life even in desparate cases with pronounced medullary involvement".


We reviewed historical reports about near dead conditions like "coma depasse" and criteria that were used to declare a person death.


Up to now, no international consensus for the diagnosis of brain death has been found. Specially the need for apparative examinations (angiography, doppler sonography, MRI, BAEP and EEG) is weightened very differently in different countries. Tendentially, the British report from 1981 (president´s commission for the study of ethical problems in medicine) has become a model for many other countries. In Japan on the other hand, most doctors agree with the concept of "whole brain death", but organ transplantation from brain dead donors is currently forbidden. In about half of the countries examined, an EEG is requrired to diagnose brain death. In Norway even flow studies are needed for a complete diagnosis.


Modern technology in its desperate attempts to save human life has produced an entity widely known as brain death. It has also generated a conceptual crisis: that of knowing - at the simplest, bedside level- whether a patient is death or alife. According to the British concept a doctor should be able to make this diagnosis without the need for any apparative diagnostic tool.