Lazarus sign and extensor posturing in a brain-dead patient

Case report

View More View Less
  • 1 Departments of Intensive Care, Neurosurgery, and Neurology, University Hospital Antwerp, Edegem, Belgium
Restricted access

Purchase Now

USD  $45.00

JNS + Pediatrics - 1 year subscription bundle (Individuals Only)

USD  $505.00

JNS + Pediatrics + Spine - 1 year subscription bundle (Individuals Only)

USD  $600.00
Print or Print + Online

✓ 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.

JNS + Pediatrics - 1 year subscription bundle (Individuals Only)

USD  $505.00

JNS + Pediatrics + Spine - 1 year subscription bundle (Individuals Only)

USD  $600.00

Contributor Notes

Address reprint requests to: L. Heytens, M.D., Department of Intensive Care, University Hospital Antwerp, Wilrijkstraat 10, B-2520 Edegem, Belgium.
  • 1.

    Allen N, , Burkholder J, & Comiscioni J: Clinical criteria of brain death. Ann NY Acad Sci 315:7096, 1978 Allen N, Burkholder J, Comiscioni J: Clinical criteria of brain death. Ann NY Acad Sci 315:70–96, 1978

    • Search Google Scholar
    • Export Citation
  • 2.

    Conference of Medical Royal Colleges and their Faculties in the United Kingdom on 11 October 1976: Diagnosis of brain death. Br Med J 2:11871188, 1976 Conference 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

    • Search Google Scholar
    • Export Citation
  • 3.

    Crüger M, , Hagenah R, & Hupe W: [ Abdominal and cremaster reflexes after trauma-induced brain death.] Prakt Anasth 11:3942, 1976 (Ger) Crüger M, Hagenah R, Hupe W: [Abdominal and cremaster reflexes after trauma-induced brain death.] Prakt Anasth 11:39–42, 1976 (Ger)

    • Search Google Scholar
    • Export Citation
  • 4.

    Ivan LP: Spinal reflexes in cerebral death. Neurology 23:650652, 1973 Ivan LP: Spinal reflexes in cerebral death. Neurology 23:650–652, 1973

    • Search Google Scholar
    • Export Citation
  • 5.

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

    • Search Google Scholar
    • Export Citation
  • 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 28:259273, 1973 Jørgenson EO: Spinal man after brain death. The unilateral extension-pronation reflex of the upper limb as an indication of brain death. Acta Neurochir 28:259–273, 1973

    • Search Google Scholar
    • Export Citation
  • 7.

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

    • Search Google Scholar
    • Export Citation
  • 8.

    Pallis C: ABC of brain stem death. Prognostic significance of a dead brain stem. Br Med J 286:123124, 1983 Pallis C: ABC of brain stem death. Prognostic significance of a dead brain stem. Br Med J 286:123–124, 1983

    • Search Google Scholar
    • Export Citation
  • 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 205:337340, 1968 Report of the Ad Hoc Committee of the Harvard Medical School to Examine the Definition of Brain Death: A definition of irreversible coma. JAMA 205:337–340, 1968

    • Search Google Scholar
    • Export Citation
  • 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 246:21842186, 1981 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 246:2184–2186, 1981

    • Search Google Scholar
    • Export Citation
  • 11.

    Ropper AH: Unusual spontaneous movements in brain-dead patients. Neurology 34:10891092, 1984 Ropper AH: Unusual spontaneous movements in brain-dead patients. Neurology 34:1089–1092, 1984

    • Search Google Scholar
    • Export Citation

Metrics

All Time Past Year Past 30 Days
Abstract Views 1848 776 49
Full Text Views 444 57 6
PDF Downloads 192 19 2
EPUB Downloads 0 0 0