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Inicio Neurología (English Edition) Cerebral death is not a synonym of whole brain death
Información de la revista
Vol. 27. Núm. 6.
Páginas 377-378 (julio - agosto 2012)
Vol. 27. Núm. 6.
Páginas 377-378 (julio - agosto 2012)
Letter to the Editor
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Cerebral death is not a synonym of whole brain death
Muerte cerebral no es un término sinónimo de muerte encefálica
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J.J. Egea-Guerrero
Autor para correspondencia
juanjoegea@hotmail.com

Corresponding author.
, J. Revuelto-Rey, E. Gordillo-Escobar
Unidad de Neurocríticos, Unidad de Gestión Clínica de Cuidados Críticos y Urgencias, Hospital Universitario Virgen del Rocío, Sevilla, Spain
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Dear Editor:

It was with great interest that we read the original article by Iriarte et al.1 regarding university students’ concepts of death defined according to neurological criteria. We agree with the authors’ view that both health professionals and society at large should possess a basic knowledge of these concepts, and the medical and legal implications which they entail. However, we would like to call attention to the term ‘muerte cerebral’ or ‘cerebral death’ which the authors use throughout the manuscript. It is true that there is a lack of uniformity among the different definitions of brain death. It is also true that while firmly established standards for diagnosing brain death do exist, the standards vary greatly from country to country.2–5 Some of the confusion arises from the way the term ‘brain death’, as defined by the Harvard criteria published in 1968, has been translated in Spanish.6 We are fully aware of the neuroanatomical differences between whole brain death, brainstem death, and neocortical or cerebral death. The first two definitions of death (based on neurological criteria) are the most widespread, and also the most polemic.7–9 All of these definitions revolve around what they consider to be the ‘brain’ in ‘brain death’. On this topic, Spanish law as cited by Iriarte et al. clearly establishes that death must be diagnosed and certified based on “irreversible cessation of cardiopulmonary functions or brain functions”.10 For this reason, we feel that using ‘cerebral death’ as a synonym for whole brain death is confusing to both health care professionals and society at large. We understand that ‘muerte cerebral’ or ‘cerebral death’ is widely used by Spanish speakers, but the term should not be employed in medicine. If the concepts employed in our definitions are inappropriately explained, the definitions themselves are more likely to be misunderstood.

References
[1]
J. Iriarte, J.A. Palma, E. Kufoy, M.J. De Miguel.
Muerte cerebral: ¿es un término adecuado?.
Neurologia, 27 (2012), pp. 16-21
[2]
W.F. Haupt, J. Rudolf.
European brain death codes: a comparison of national guidelines.
J Neurol, 236 (1999), pp. 432-437
[3]
D.M. Greer, P.N. Varelas, S. Haque, E.F. Wijdicks.
Variability of brain death determination guidelines in leading US neurologic institutions.
Neurology, 22 (2008), pp. 284-289
[4]
J.J. Egea-Guerrero, A. Illescas-Vacas, M. Juan-Díaz, J. Revuelto-Rey, A. Serrano-Lázaro, J. Domínguez-Roldán.
Brain death. Diferencias en el concepto de muerte encefálica con el Reino Unido.
Actualizaciones en trasplantes 2009, 1st ed., pp. 101-104
[5]
A.M. Capron.
Brain death – well settled yet still unresolved.
N Engl J Med, 344 (2001), pp. 1244-1246
[6]
A definition of irreversible coma. Report of the Ad Hoc Committee of the Harvard Medical. School to examine the definition of brain death.
JAMA, 205 (1968), pp. 337-340
[7]
A. Mohandas, S.N. Chou.
Brain death: a clinical and pathological study.
J Neurosurg, 35 (1971), pp. 211-218
[8]
C. Machado-Curbelo.
¿Defendemos una visión encefálica de la muerte?.
Rev Neurol, 35 (2002), pp. 387-396
[9]
M.D. Bell, E. Moss, P.G. Murphy.
Brainstem death testing in the UK-time for reappraisal?.
Br J Anaesth, 92 (2004), pp. 633-640
[10]
Boletín Oficial del Estado de España, BOE 4 de enero de 2000. Ministerio de la Presidencia. Real Decreto 2070/1999.

Please cite this article as: Egea-Guerrero JJ, et al. Muerte cerebral no es un término sinónimo de muerte encefálica. Neurología. 2012;27:377–8.

Copyright © 2011. Sociedad Española de Neurología
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