ArticleNeurocritical care2017
Primary Posterior Fossa Lesions and Preserved Supratentorial Cerebral Blood Flow: Implications for Brain Death Determination.
Article in Neurocritical care, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 15 papers.
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Who cites it
15 citing papers in PubMed, 41 citations in OpenAlex.
- Isolated brainstem death: case presentation demonstrating preserved supratentorial perfusion onEJNMMI reports · 2026Article
- Apnea Testing in Brain Death Due to Primary Posterior Fossa Injury.Neurocritical care · 2025Article
- Challenges to Brain Death in Revising the Uniform Determination of Death Act: The UDDA Revision Series.Neurology · 2023Article
- The reticular activating system: a narrative review of discovery, evolving understanding, and relevance to current formulations of brain death.Canadian journal of anaesthesia = Journal canadien d'anesthesie · 2023Review
- What does "brainstem death" mean? A review of international protocols.Canadian journal of anaesthesia = Journal canadien d'anesthesie · 2023Review
- Infratentorial brain injury and death by neurologic criteria in Canada: a narrative review.Canadian journal of anaesthesia = Journal canadien d'anesthesie · 2023Review
- Reader Response: Infratentorial Brain Injury Among Patients Suspected of Death by Neurologic Criteria: A Systematic Review and Meta-analysis.Neurology · 2023Article
- Author Response: Infratentorial Brain Injury Among Patients Suspected of Death by Neurologic Criteria: A Systematic Review and Meta-analysis.Neurology · 2023Article
- Brain herniation on computed tomography is a poor predictor of whether patients with a devastating brain injury can be confirmed dead using neurological criteria.Journal of the Intensive Care Society · 2022Article
- Brain death: a clinical overview.Journal of intensive care · 2022Review
- Flow is not perfusion, and perfusion is not function: ancillary testing for the diagnosis of brain death.Canadian journal of anaesthesia = Journal canadien d'anesthesie · 2021Article
- Neurological determination of death in isolated brainstem lesions: A case report to highlight the issues involved.Journal of the Intensive Care Society · 2020Article
- [Diagnosis of irreversible loss of brain function ("brain death")-what is new?]Der Nervenarzt · 2019Review
- The observation period after clinical brain death diagnosis according to ancillary tests: differences between supratentorial and infratentorial brain injury.Journal of neurology · 2019Observational
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Authors and funding
7 authors at 4 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundPatients with primary posterior fossa catastrophic lesions may clinically meet brain death criteria, but may retain supratentorial brain function or blood flow. These patients could be declared brain-dead in the United Kingdom (UK), but not in the United States of America (USA). We report the outcome of adult patients with primary posterior fossa lesions without concurrent major supratentorial injury.
methodsHenry Ford Hospital database was reviewed over a period of 88 months in order to identify all adult patients with isolated brainstem or posterior fossa lesions. We excluded patients with concurrent significant supratentorial pathology potentially confounding the clinical brain death examination. One more patient from a different hospital meeting these criteria was also included.
resultsThree patients out of 161 met inclusion criteria (1.9% of all brain deaths during this period). With the addition of a fourth patient from another hospital, 4 patients were analyzed. All four patients had catastrophic brainstem and cerebellar injuries meeting the clinical criteria of brain death with positive apnea test in the UK. All had preserved supratentorial blood flow, which after a period of 2 h to 6 days disappeared on repeat testing, allowing declaration of brain death by US criteria in all four. One patient became an organ donor.
conclusionsPatients with primary posterior fossa catastrophic lesions, who clinically seem to be brain-dead, evolve from retaining to losing supratentorial blood flow. If absent cerebral blood flow is used as an additional criterion for the declaration of death by neurological criteria, these patients are not different than those who become brain death due to supratentorial lesions.
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