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September 1985

Auditory Brain-Stem Response in Determination of Brain Death

Author Affiliations

From the University of Texas Medical School (Drs Hall, Mackey-Hargadine, and Kim), and the Audiology Service, Hermann Hospital (Dr Hall), Houston.

Arch Otolaryngol. 1985;111(9):613-620. doi:10.1001/archotol.1985.00800110091010

• A diagnosis of brain death requires evidence of irreversible destruction (or dysfunction) of neurons in the brain stem and cerebrum. The physical examination is not a valid index of brain integrity in patients who are drug-intoxicated or receiving therapeutic paralyzing agents or high-dose barbiturates. We evaluated the use of the auditory brain-stem response (ABR) as an ancillary test in the determination of brain death. A total of 100 combined ABR and nuclear cerebral blood flow studies were completed at bedside with 81 acute, severely braininjured adults. The ABR and cerebral blood flow outcomes were significantly correlated. We conclude that the ABR is a clinically feasible and useful procedure in the determination of brain death, especially in patients whose medical therapy compromises the neurologic examination.

(Arch Otolaryngol 1985;111:613-620)

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