Edited by John D. Archer, MD, Senior Editor.
To the Editor.— Radionuclide cerebral imaging (RCI) has been well established as a confirmation of brain death.1-3 However, the proved utility of the procedure is overstated in the recent article by Schwartz et al (1983; 249:246), largely because it confuses cerebral blood flow with intracranial. Also, the authors overstate the importance of demonstrating correlation between two tests in a selected population of patients.Documentation of absent intracranial blood flow can at present only be achieved by four-vessel contrast angiography, which examines blood flow to both the cerebrum and the posterior fossa. This study, repeated to show persistence for a period (ten minutes is recommended), is unequivocal evidence of "irreversible cessation of all functions of the entire brain"—brain death—even if circumstances preclude determination of cause or a comprehensive neurological examination.However, the same cannot be said for a test such as RCI that evaluates only cerebral blood flow, not posterior
Country-Specific Mortality and Growth Failure in Infancy and Yound Children and Association With Material Stature
Use interactive graphics and maps to view and sort country-specific infant and early dhildhood mortality and growth failure data and their association with maternal
Instructions
Comments are moderated and will appear on the site at the discretion of the Journal of American Medical Association editors. Comments should not exceed 500 words of text and 10 references.
Do not submit personal medical questions or information that could identify a specific patient, questions about a particular case, or general inquiries to an author. Only content that has not been published, posted, or submitted elsewhere should be submitted. By submitting this Comment, you and any coauthors transfer copyright to the journal if your Comment is posted.
* = Required Field
Disclosure of Any Conflicts of Interest* Indicate all relevant conflicts of interest of each author below, including all relevant financial interests, activities, and relationships within the past 3 years including, but not limited to, employment, affiliation, grants or funding, consultancies, honoraria or payment, speakers’ bureaus, stock ownership or options, expert testimony, royalties, donation of medical equipment, or patents planned, pending, or issued. If all authors have none, check "No potential conflicts or relevant financial interests" in the box below. Please also indicate any funding received in support of this work. The information will be posted with your response.
Register and get free email Table of Contents alerts, saved searches, PowerPoint downloads, CME quizzes, and more
Subscribe for full-text access to content from 1998 forward and a host of useful features
Activate your current subscription (AMA members and current subscribers)
Some tools below are only available to our subscribers or users with an online account.
Download citation file:
Customize your page view by dragging & repositioning the boxes below.
and access these and other features:
Register Now
Enter your username and email address. We'll send you a reminder to the email address on record.
Athens and Shibboleth are access management services that provide single sign-on to protected resources. They replace the multiple user names and passwords necessary to access subscription-based content with a single user name and password that can be entered once per session. It operates independently of a user's location or IP address. If your institution uses Athens or Shibboleth authentication, please contact your site administrator to receive your user name and password.