Brain death + Coma

Question 1

3 criteria to be classified as brain dead

Answer 1

1. apnoea (no breathing) > 5 mins
2. no brainstem signs
3. GCS 3 (comatose)

Question 2

what are the brainstem signs that are missing in brain dead px

Answer 2

no corneal, caloric, cough reflex
fixed dilated pupil
no response to pain

Question 3

what is comatose posturing

Answer 3

abnormal body positions seen in unconscious patients, usually due to severe brain injury

Question 4

2 types of comatose posturing

Answer 4

1. de corticate
2. de cerebrate

Question 5

describe de corticate position

Answer 5

• arms flexed to chest
• either lesion or problem with brain cortex
• good prognosis

Question 6

describe de cerebrate

Answer 6

• arms extended and pronated
• brainstem lesion
• poor prognosis

Question 7

what happens if you go from de corticate to cerebrate

Answer 7

tonsular herniation