Brain death Home A-Z Health Information Health Library A-Z Brain Death Overview Brain death is the permanent and irreversible cessation of arousal, wakefulness, accompanied by total and irreversible loss of brain stem reflexes, including breathing, coughing, eye movement, and swallowing. Causes Hypoxic brain damageTraumaVascular- ischemic / haemorrhagic strokeFulminant systemic/ brain infectionsInflammatory conditions- vasculitisAutoimmune conditions- neurosarcoidosis Risk factors Cardiopulmonary arrestTraumatic brain injurySubarachnoid haemorrhageIntracerebral haemorrhageOther causes of brain death include heart attack, stroke, blood clot, infections like encephalitis or meningitis, and brain tumour Diagnosis Fixed pupils with no response to lightAbsence of corneal or conjunctival reflexNo response on caloric testingAbsence of spontaneous breathingAbsence of gag reflexNo motor response to painful stimulusNo respiratory movements on disconnection from ventilator, even after increase in CO2 in blood Pre-requisites before declaring a patient brain death The aetiology for irreversible brain damage should be confirmed.The causes of coma such as sedative medications, hypothermia, metabolic and endocrine causes should be excludedThe Patient should be hemodynamically stable on ventilator