Lazarus sign and extensor posturing in a brain-dead patient

Case report

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✓ A man was declared brain dead after having sustained a gunshot wound to the head. All clinical criteria for the diagnosis of brain death were met. The electroencephalogram was isoelectric, and four-vessel angiography demonstrated the absence of cerebral blood flow. However, stereotypic spontaneous movements were observed which persisted for several hours. The possible mechanism is discussed and a short review of the literature is given.

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Address reprint requests to: L. Heytens, M.D., Department of Intensive Care, University Hospital Antwerp, Wilrijkstraat 10, B-2520 Edegem, Belgium.

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References

1.

Allen NBurkholder JComiscioni J: Clinical criteria of brain death. Ann NY Acad Sci 315:70961978Allen N Burkholder J Comiscioni J: Clinical criteria of brain death. Ann NY Acad Sci 315:70–96 1978

2.

Conference of Medical Royal Colleges and their Faculties in the United Kingdom on 11 October 1976: Diagnosis of brain death. Br Med J 2:118711881976Conference of Medical Royal Colleges and their Faculties in the United Kingdom on 11 October 1976: Diagnosis of brain death. Br Med J 2:1187–1188 1976

3.

Crüger MHagenah RHupe W: [Abdominal and cremaster reflexes after trauma-induced brain death.] Prakt Anasth 11:39421976 (Ger)Crüger M Hagenah R Hupe W: [Abdominal and cremaster reflexes after trauma-induced brain death.] Prakt Anasth 11:39–42 1976 (Ger)

4.

Ivan LP: Spinal reflexes in cerebral death. Neurology 23:6506521973Ivan LP: Spinal reflexes in cerebral death. Neurology 23:650–652 1973

5.

Jordan JEDyess ECliett J: Unusual spontaneous movements in brain-dead patients. Neurology 35:10821985 (Letter)Jordan JE Dyess E Cliett J: Unusual spontaneous movements in brain-dead patients. Neurology 35:1082 1985 (Letter)

6.

Jørgenson EO: Spinal man after brain death. The unilateral extension-pronation reflex of the upper limb as an indication of brain death. Acta Neurochir 28:2592731973Jørgenson EO: Spinal man after brain death. The unilateral extension-pronation reflex of the upper limb as an indication of brain death. Acta Neurochir 28:259–273 1973

7.

Mandel SArenas AScasta D: Spinal automatism in cerebral death. N Engl J Med 307:5011982 (Letter)Mandel S Arenas A Scasta D: Spinal automatism in cerebral death. N Engl J Med 307:501 1982 (Letter)

8.

Pallis C: ABC of brain stem death. Prognostic significance of a dead brain stem. Br Med J 286:1231241983Pallis C: ABC of brain stem death. Prognostic significance of a dead brain stem. Br Med J 286:123–124 1983

9.

Report of the Ad Hoc Committee of the Harvard Medical School to Examine the Definition of Brain Death: A definition of irreversible coma. JAMA 205:3373401968Report of the Ad Hoc Committee of the Harvard Medical School to Examine the Definition of Brain Death: A definition of irreversible coma. JAMA 205:337–340 1968

10.

Report of the Medical Consultants on the Diagnosis of Death to the President's Commission for the Study of Ethical Problems in Medicine and Biomedical and Behavioral Research: Guidelines for the determination of death. JAMA 246:218421861981Report of the Medical Consultants on the Diagnosis of Death to the President's Commission for the Study of Ethical Problems in Medicine and Biomedical and Behavioral Research: Guidelines for the determination of death. JAMA 246:2184–2186 1981

11.

Ropper AH: Unusual spontaneous movements in brain-dead patients. Neurology 34:108910921984Ropper AH: Unusual spontaneous movements in brain-dead patients. Neurology 34:1089–1092 1984

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