Frowein R A, Gänshirt H, Richard K E, Hamel E, Haupt W F
Anasth Intensivther Notfallmed. 1987 Feb;22(1):17-20.
The criteria of brain death published by the Federal Chamber of Physicians in 1982 in their second generation have stood the test of time and remain valid. The most important amendments in issuing a third generation are the following: In primary cerebral lesions supratentorial lesions have to be distinguished from infratentorial processes. In primarily the infratentorial processes EEG activities of the cortex max outlast apneic brain stem areflexia. Therefore in infratentorial processes controls of the EEG are indispensable. The extinction of evoked potentials, certain conditions being observed, may prove the loss of brain stem function and therefore may allow to shorten observation time, and may offer an alternative to isoelectricity in the EEG or cerebral perfusion stop as a diagnostic procedure. Additional tests for brain death are commented on. Special considerations are necessary in brain death in children.
德国医师协会1982年发布的第二代脑死亡标准经受住了时间的考验，仍然有效。发布第三代标准时最重要的修订如下：在原发性脑部病变中，幕上病变必须与幕下病变区分开来。在原发性幕下病变中，皮质的脑电图活动比呼吸暂停时脑干无反射持续的时间更长。因此，在幕下病变中，脑电图检查是必不可少的。在观察到某些条件时，诱发电位的消失可能证明脑干功能丧失，因此可以缩短观察时间，并且可以作为脑电图等电位或脑灌注停止的替代诊断程序。文中还对脑死亡的其他检查进行了评论。儿童脑死亡需要特殊考虑。
