Cortical Death and Brainstem Death
Pathophysiology of Cortical Death
Cortical death is the irreversible loss of higher cerebral function while brainstem reflexes persist. This article explores its pathophysiology, clinical features, and diagnostic criteria.
Cortical Death and Brainstem Death
Pathophysiology of Cortical Death
Cortical death is characterized by irreversible loss of cerebral cortical function while brainstem activity persists. It results from extensive neuronal injury leading to loss of consciousness and cognitive functions.
Causes of Cortical Death
- Hypoxic-ischemic encephalopathy
- Severe traumatic brain injury
- Neurodegenerative diseases
- Massive cerebral infarctions
Clinical Presentation
Patients with cortical death exhibit unresponsiveness, absence of higher cognitive functions, and profound coma, but retain autonomic and brainstem reflexes.
Diagnostic Criteria
- Electroencephalography (EEG) showing absence of cortical activity
- Imaging demonstrating extensive cortical atrophy
- Neurological examination confirming irreversible unconsciousness
Comparison: Brainstem Death vs. Cortical Death
Brainstem death involves irreversible cessation of all brainstem functions, including respiration, whereas cortical death retains brainstem reflexes while higher cerebral activities are lost.
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