Robert F, Mumenthaler M
Schweiz Med Wochenschr. 1977 Mar 12;107(10):335-41.
In 45 patients without spontaneous breathing or cranial reflexes, and in whom blood pressure had to be supported, spinal reflexes were obtained in 60% and polysynaptic spinal reflexes in 33%. In all cases angiography showed cerebral circulatory arrest and/or repeated EEG recording gave an isoelectric line. The presence of spinal reflexes, appearing most frequently 6-36 h after death (which we defined as a sudden fall in blood pressure below 80 mm Hg with absence of spontaneous breathing) is not in contradiction with the assumption of brain death. 9 patients without signs of intoxication showed, in addition, a fall in body temperature below 34 degrees C. Such a fall in body temperature also in agreement with the diagnosis of brain death.