The application was made as BN’s foster mother, PS, at that time, disagreed. The Trust made a Part 8 claim for a declaration that BN had died due to an irreversible absence of brain-stem functioning, and consequently sought permission for mechanical ventilation and all ancillary care and treatment to be withdrawn. The tests were repeated some 45 minutes later which had exactly the same response.
BRAIN STEM CODE
The 2008 Code confirms that: “ irreversible cessation of the integrative function of the brain-stem equates with the death of the individual and allows the medical practitioner to diagnose death”. Those tests were carried out to completion and were concluded at 11.45 on 10 March 2022, and that, say the treating team, is the time and date of death – the doctors being satisfied that the tests demonstrated the irreversible cessation of brain-stem function. The Trust sought second opinions from two other trusts before carrying out brain stem testing in line with the 2008 Code of Practice for the Diagnosis and Confirmation of Death (the 2008 Code). North West Anglia NHS Foundation Trust v BN & Anor EWHC 663 (Fam)īN was a lady in her mid-forties who sadly suffered a severe haemorrhage, leaving her unresponsive and unable to breathe on her own. There have been two cases before the Family Division of the High Court in recent months which are worth drawing to your attention: 11, 690–699 (1991).We have recently been advising NHS Trust clients in connection with disagreements between clinicians and family members over (a) whether or not to conduct brain stem death testing, and (b) the withdrawal of ventilation and treatment after testing has confirmed brain stem death. Comparing functional (PET) images: The assessment of significant change. The relationship between global and local changes in PET scans. Coplanar Stereotaxic Atlas of the Human Brain (Thieme, New York, 1988).įriston, K.J., Frith, C.D., Liddle, P.F. Rapid automated algorithm for aligning and reslicing PET images. Combination of dynamic and integral methods for generating reproducible functional CBF images. Classification and diagnostic criteria for headache disorders, cranial neuralgias and facial pain. 31, 291–294 (1991).Ĭommittee of the International Headache Society. The clinical pharmacology, pharmacokinetics and metabolism of sumatriptan.
Inhibition by sumatriptan of central trigeminal neurones only after blood-brain barrier disruption. Comparison of the antinociceptive effect of morphine and glutamate at coincidental sites in the periaqueductal gray and medial medulla in rat. Evidence that an excitatory connection between the periaqueductal gray and nucleus raphe magnus mediates stimulation produced analgesia. Central nervous pathways mediating angina pectoris. Positron emission tomographic analysis of cerebral structures activated specifically by repetitive noxious heat stimuli. Localization of responses to pain in human cerebral cortex. Functional neuroanatomy of the human brain: Positron emission tomography-a new neuroanatomical technique. Noninvasive functional brain mapping by change-distribution analysis of averaged PET images of H2 15O tissue activity. Bilateral spreading cerebral hypoperfusion during spontaneous migraine headache. Cerebral blood flow during migraine attacks without aura and effect of sumatriptan. The common migraine attack may not be initiated by cerebral ischaemia. Olesen, J., Tfelt-Hansen, P., Henriksen, L. Focal hyperemia followed by spreading oligemia and impaired activation of rCBF in classic migraine. A single photon emission computerized tomography study. Interictal “patchy” regional cerebral blood flow patterns in migraine patients. (Raven Press, New York, 1991).įriberg, L. Migraine and Other Headaches: The Vascular Mechanisms. Headache may arise from perturbation of brain. Localisation of 3H-dihydroergotamine-binding sites in the cat central nervous system: Relevance to migraine. & Edvinsson, L.) 413–426 (Elsevier Science Publishers, Amsterdam, 1988).
Brain stem effects on intra- and extracerebral circulations, in Basic Mechanisms of Headache (eds Olesen, J. A concept of migraine and the search for the ideal headache drug.
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