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The phenomenon has been observed to occur several minutes after the removal of medical ventilators used to pump air in and out of brain-dead patients. [4] It also occurs during testing for apnea—that is, suspension of external breathing and motion of the lung muscles—which is one of the criteria for determining brain death used for example by the American Academy of Neurology.
Brain death is used as an indicator of legal death in many jurisdictions, [6] but it is defined inconsistently and often confused by the public. [7] Various parts of the brain may keep functioning when others do not anymore, and the term "brain death" has been used to refer to various combinations.
The certification applies to somatic death, corresponding to death of the person, which has varying definitions but most commonly describes a lack of vital signs and brain function. [9] Death at the level of cells, called molecular death or cell death , follows a matter of hours later. [ 10 ]
Brainstem death is a clinical syndrome defined by the absence of reflexes with pathways through the brainstem – the "stalk" of the brain, which connects the spinal cord to the mid-brain, cerebellum and cerebral hemispheres – in a deeply comatose, ventilator-dependent patient.
The test is commonly used by physicians, audiologists and other trained professionals to validate a diagnosis of asymmetric function in the peripheral vestibular system. Calorics are usually a subtest of the electronystagmography (ENG) battery of tests. It is one of several tests which can be used to test for brain stem death.
A neurological examination is the assessment of sensory neuron and motor responses, especially reflexes, to determine whether the nervous system is impaired. This typically includes a physical examination and a review of the patient's medical history, [1] but not deeper investigation such as neuroimaging.
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The test, which can be self-administered or given by an interviewer, asks patients to rate the severity of 16 different symptoms commonly found after a mild traumatic brain injury (MTBI). [6] Patients are asked to rate how severe each of the 16 symptoms has been over the past 24 hours.