Evidence map›Paper›PMID 36220596›Full record

SynthesisNeurology2023

Infratentorial Brain Injury Among Patients Suspected of Death by Neurologic Criteria: A Systematic Review and Meta-analysis.

Joel Neves Briard, Guillaume Plourde, Roy Nitulescu, J Gordon Boyd, François Martin Carrier, Philippe Couillard, Mark R Keezer, Andreas H Kramer, Sam D Shemie, Christian Stapf and 1 more

Abstract readMeta-AnalysisSystematic Review
PubMed Publisher
In one paragraph

Synthesis in Neurology, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed
2.4field-weighted citation impact, top 12% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

5 citing papers in PubMed, 12 citations in OpenAlex.

  1. Article
  2. Article
  3. Infratentorial brain injury and death by neurologic criteria in Canada: a narrative review.Canadian journal of anaesthesia = Journal canadien d'anesthesie · 2023
    Review
  4. Article
  5. Article
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

11 authors at 1 institution in 1 country.

Joel Neves BriardFrom the Departments of Neuroscience (J.N.B., M.R.K., C.S.) Medicine (G.P., M.C.), and Anesthesiology and Pain Medicine (F.M.C.), Université de Montréal, Québec, Canada; Centre de Recherche Du Centre Hospitalier de l'Université de Montréal (CRCHUM) (J.N.B., G.P., R.N., F.M.C., M.R.K., C.S., M.C.), Québec, Canada; Department of Social and Preventative Medicine (J.N.B., M.R.K., M.C.), École de Santé Publique de l'Université de Montréal, Québec, Canada; Departments of Medicine and Critical Care (J.G.B.), Queen's University, Kingston, Ontario, Canada; Departments of Critical Care Medicine & Clinical Neurosciences (P.C., A.H.K.), University of Calgary, Alberta, Canada; and Department of Pediatrics (S.D.S.), McGill University, Montréal, Québec, Canada.ORCID https://orcid.org/0000-0002-1576-5669
Guillaume PlourdeFrom the Departments of Neuroscience (J.N.B., M.R.K., C.S.) Medicine (G.P., M.C.), and Anesthesiology and Pain Medicine (F.M.C.), Université de Montréal, Québec, Canada; Centre de Recherche Du Centre Hospitalier de l'Université de Montréal (CRCHUM) (J.N.B., G.P., R.N., F.M.C., M.R.K., C.S., M.C.), Québec, Canada; Department of Social and Preventative Medicine (J.N.B., M.R.K., M.C.), École de Santé Publique de l'Université de Montréal, Québec, Canada; Departments of Medicine and Critical Care (J.G.B.), Queen's University, Kingston, Ontario, Canada; Departments of Critical Care Medicine & Clinical Neurosciences (P.C., A.H.K.), University of Calgary, Alberta, Canada; and Department of Pediatrics (S.D.S.), McGill University, Montréal, Québec, Canada.
Roy NitulescuFrom the Departments of Neuroscience (J.N.B., M.R.K., C.S.) Medicine (G.P., M.C.), and Anesthesiology and Pain Medicine (F.M.C.), Université de Montréal, Québec, Canada; Centre de Recherche Du Centre Hospitalier de l'Université de Montréal (CRCHUM) (J.N.B., G.P., R.N., F.M.C., M.R.K., C.S., M.C.), Québec, Canada; Department of Social and Preventative Medicine (J.N.B., M.R.K., M.C.), École de Santé Publique de l'Université de Montréal, Québec, Canada; Departments of Medicine and Critical Care (J.G.B.), Queen's University, Kingston, Ontario, Canada; Departments of Critical Care Medicine & Clinical Neurosciences (P.C., A.H.K.), University of Calgary, Alberta, Canada; and Department of Pediatrics (S.D.S.), McGill University, Montréal, Québec, Canada.
J Gordon BoydFrom the Departments of Neuroscience (J.N.B., M.R.K., C.S.) Medicine (G.P., M.C.), and Anesthesiology and Pain Medicine (F.M.C.), Université de Montréal, Québec, Canada; Centre de Recherche Du Centre Hospitalier de l'Université de Montréal (CRCHUM) (J.N.B., G.P., R.N., F.M.C., M.R.K., C.S., M.C.), Québec, Canada; Department of Social and Preventative Medicine (J.N.B., M.R.K., M.C.), École de Santé Publique de l'Université de Montréal, Québec, Canada; Departments of Medicine and Critical Care (J.G.B.), Queen's University, Kingston, Ontario, Canada; Departments of Critical Care Medicine & Clinical Neurosciences (P.C., A.H.K.), University of Calgary, Alberta, Canada; and Department of Pediatrics (S.D.S.), McGill University, Montréal, Québec, Canada.
François Martin CarrierFrom the Departments of Neuroscience (J.N.B., M.R.K., C.S.) Medicine (G.P., M.C.), and Anesthesiology and Pain Medicine (F.M.C.), Université de Montréal, Québec, Canada; Centre de Recherche Du Centre Hospitalier de l'Université de Montréal (CRCHUM) (J.N.B., G.P., R.N., F.M.C., M.R.K., C.S., M.C.), Québec, Canada; Department of Social and Preventative Medicine (J.N.B., M.R.K., M.C.), École de Santé Publique de l'Université de Montréal, Québec, Canada; Departments of Medicine and Critical Care (J.G.B.), Queen's University, Kingston, Ontario, Canada; Departments of Critical Care Medicine & Clinical Neurosciences (P.C., A.H.K.), University of Calgary, Alberta, Canada; and Department of Pediatrics (S.D.S.), McGill University, Montréal, Québec, Canada.
Philippe CouillardFrom the Departments of Neuroscience (J.N.B., M.R.K., C.S.) Medicine (G.P., M.C.), and Anesthesiology and Pain Medicine (F.M.C.), Université de Montréal, Québec, Canada; Centre de Recherche Du Centre Hospitalier de l'Université de Montréal (CRCHUM) (J.N.B., G.P., R.N., F.M.C., M.R.K., C.S., M.C.), Québec, Canada; Department of Social and Preventative Medicine (J.N.B., M.R.K., M.C.), École de Santé Publique de l'Université de Montréal, Québec, Canada; Departments of Medicine and Critical Care (J.G.B.), Queen's University, Kingston, Ontario, Canada; Departments of Critical Care Medicine & Clinical Neurosciences (P.C., A.H.K.), University of Calgary, Alberta, Canada; and Department of Pediatrics (S.D.S.), McGill University, Montréal, Québec, Canada.
Mark R KeezerFrom the Departments of Neuroscience (J.N.B., M.R.K., C.S.) Medicine (G.P., M.C.), and Anesthesiology and Pain Medicine (F.M.C.), Université de Montréal, Québec, Canada; Centre de Recherche Du Centre Hospitalier de l'Université de Montréal (CRCHUM) (J.N.B., G.P., R.N., F.M.C., M.R.K., C.S., M.C.), Québec, Canada; Department of Social and Preventative Medicine (J.N.B., M.R.K., M.C.), École de Santé Publique de l'Université de Montréal, Québec, Canada; Departments of Medicine and Critical Care (J.G.B.), Queen's University, Kingston, Ontario, Canada; Departments of Critical Care Medicine & Clinical Neurosciences (P.C., A.H.K.), University of Calgary, Alberta, Canada; and Department of Pediatrics (S.D.S.), McGill University, Montréal, Québec, Canada.
Andreas H KramerFrom the Departments of Neuroscience (J.N.B., M.R.K., C.S.) Medicine (G.P., M.C.), and Anesthesiology and Pain Medicine (F.M.C.), Université de Montréal, Québec, Canada; Centre de Recherche Du Centre Hospitalier de l'Université de Montréal (CRCHUM) (J.N.B., G.P., R.N., F.M.C., M.R.K., C.S., M.C.), Québec, Canada; Department of Social and Preventative Medicine (J.N.B., M.R.K., M.C.), École de Santé Publique de l'Université de Montréal, Québec, Canada; Departments of Medicine and Critical Care (J.G.B.), Queen's University, Kingston, Ontario, Canada; Departments of Critical Care Medicine & Clinical Neurosciences (P.C., A.H.K.), University of Calgary, Alberta, Canada; and Department of Pediatrics (S.D.S.), McGill University, Montréal, Québec, Canada.
Sam D ShemieFrom the Departments of Neuroscience (J.N.B., M.R.K., C.S.) Medicine (G.P., M.C.), and Anesthesiology and Pain Medicine (F.M.C.), Université de Montréal, Québec, Canada; Centre de Recherche Du Centre Hospitalier de l'Université de Montréal (CRCHUM) (J.N.B., G.P., R.N., F.M.C., M.R.K., C.S., M.C.), Québec, Canada; Department of Social and Preventative Medicine (J.N.B., M.R.K., M.C.), École de Santé Publique de l'Université de Montréal, Québec, Canada; Departments of Medicine and Critical Care (J.G.B.), Queen's University, Kingston, Ontario, Canada; Departments of Critical Care Medicine & Clinical Neurosciences (P.C., A.H.K.), University of Calgary, Alberta, Canada; and Department of Pediatrics (S.D.S.), McGill University, Montréal, Québec, Canada.
Christian StapfFrom the Departments of Neuroscience (J.N.B., M.R.K., C.S.) Medicine (G.P., M.C.), and Anesthesiology and Pain Medicine (F.M.C.), Université de Montréal, Québec, Canada; Centre de Recherche Du Centre Hospitalier de l'Université de Montréal (CRCHUM) (J.N.B., G.P., R.N., F.M.C., M.R.K., C.S., M.C.), Québec, Canada; Department of Social and Preventative Medicine (J.N.B., M.R.K., M.C.), École de Santé Publique de l'Université de Montréal, Québec, Canada; Departments of Medicine and Critical Care (J.G.B.), Queen's University, Kingston, Ontario, Canada; Departments of Critical Care Medicine & Clinical Neurosciences (P.C., A.H.K.), University of Calgary, Alberta, Canada; and Department of Pediatrics (S.D.S.), McGill University, Montréal, Québec, Canada.
Michaël ChasséFrom the Departments of Neuroscience (J.N.B., M.R.K., C.S.) Medicine (G.P., M.C.), and Anesthesiology and Pain Medicine (F.M.C.), Université de Montréal, Québec, Canada; Centre de Recherche Du Centre Hospitalier de l'Université de Montréal (CRCHUM) (J.N.B., G.P., R.N., F.M.C., M.R.K., C.S., M.C.), Québec, Canada; Department of Social and Preventative Medicine (J.N.B., M.R.K., M.C.), École de Santé Publique de l'Université de Montréal, Québec, Canada; Departments of Medicine and Critical Care (J.G.B.), Queen's University, Kingston, Ontario, Canada; Departments of Critical Care Medicine & Clinical Neurosciences (P.C., A.H.K.), University of Calgary, Alberta, Canada; and Department of Pediatrics (S.D.S.), McGill University, Montréal, Québec, Canada. michael.chasse@umontreal.ca.
Queen's University · CA

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

BACKGROUND AND

objectivesThere is a paucity of data on the frequency and prognosis of infratentorial brain injury among patients suspected of death by neurologic criteria (DNC), which likely contributes to scientific uncertainty regarding the role of isolated brainstem death in DNC determination. Our aim was to synthesize the prevalence, characteristics, and evolution of infratentorial brain injury, including isolated brainstem death, among patients suspected of DNC.

methodsWe conducted a systematic review by searching Medline, Embase, EBM Reviews, CINAHL Complete, and the gray literature from inception to March 26, 2021. We selected cohort and cross-sectional studies, case reports, and case series that included patients suspected of DNC. Two study investigators independently performed study selection, data collection, and risk of bias assessment. Our primary outcomes were the respective prevalence of infratentorial brain injury and isolated brainstem death, which we meta-analyzed using mixed-effects Bayesian hierarchical models with diffuse priors. Our secondary outcomes were the characteristics and evolution of patients with infratentorial brain injury and isolated brainstem death.

resultsTwenty-one studies met the selection criteria, most of which were of moderate to high risk of bias. Among patients suspected of DNC, the prevalence of infratentorial brain injury ranged from 2% to 16% (n = 3,602, mean prevalence: 6.3%, 95% highest density interval [2.4%-14.2%]), whereas the prevalence of isolated brainstem death ranged from 1% to 4% (n = 3,692, mean prevalence: 1.5%, 95% highest density interval [0.5%-3.9%]). A total of 38 isolated brainstem death cases with data on clinical characteristics and/or evolution were included. All had infratentorial strokes. Twenty patients had EEG background activity in the α or θ frequencies, 19 had preserved cerebral blood flow, 2 had preserved supratentorial cerebral perfusion, 2 had cortical responses to visual evoked potentials, and 1 had cortical responses to somatosensory evoked potentials. At the latest follow-up, 28 had progressed to whole-brain death. DISCUSSION: Studies with moderate to high risk of bias suggest that infratentorial brain injury is relatively uncommon among patients suspected of DNC. Isolated brainstem death is rarer and seems to carry a high risk of progression to whole-brain death. These findings require further high-quality investigation.

Indexed as

Brain DeathBrain InjuriesBayes TheoremCross-Sectional StudiesEvoked Potentials, VisualHumans

Identifiers

PMID36220596
OpenAlexW4304607424

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.