Scherzer E
Neurotraumatologischen Rehabilitationszentrum Wien-Meidling, Allgemeinen Unfallversicherungsanstalt Osterreichs.
Wien Med Wochenschr. 1990;140(23-24):562-4.
Cerebral death occurs during reanimation as an isolated destruction of the entire brain. It is the result of a malignant and irreversible increase of the intracranial pressure. Continuous registration of the intracranial and systemic blood pressures which is done as a routine monitoring procedure in the majority of deep coma patients, allows to identify the moment when cerebral perfusion has come to a complete standstill, and also allows to confirm its irreversibility. At the end of an ischaemic period of 8 to 10 minutes, absolutely lethal to brain tissue, cerebral death is completed. To be on the safe side, the expiration of a 15 to 20 minute period of complete circulatory arrest within the cranial cavity is recommended before further diagnostic measures, especially cerebral arteriography, are undertaken as final proof of dissociated brain death, permitting the explantation of vital organs for grafting. At present, due to possible technical difficulties, reliance upon epidural intracranial pressure measurement alone must still be discouraged. Nevertheless, this investigation method can be most useful in the early timing of the so-called terminal angiography in order not to delay the diagnosis of brain death and its medical consequences.
脑死亡发生在复苏过程中，表现为整个大脑的孤立性破坏。它是颅内压恶性且不可逆升高的结果。在大多数深度昏迷患者中，作为常规监测程序进行的颅内和全身血压连续记录，能够确定脑灌注完全停止的时刻，并能确认其不可逆性。在对脑组织具有绝对致死性的8至10分钟缺血期结束时，脑死亡完成。为安全起见，在采取进一步诊断措施（尤其是脑动脉造影术）作为分离性脑死亡的确切证据、允许摘取重要器官进行移植之前，建议在颅腔内完全循环停止15至20分钟后进行。目前，由于可能存在的技术困难，仍应避免仅依赖硬膜外颅内压测量。然而，这种检查方法在所谓的终末血管造影早期计时方面可能非常有用，以免延误脑死亡的诊断及其医学后果。
