Topic: Brain Death
Subject: Medicine
A 30 year old man has been on life support systems for the past 48 hours following blunt head trauma. Brain death cannot be established in this patient if there is the presence of which of the following?

Hypothermia should be excluded before making a diagnosis of brain death. If present, it can be the cause of a flat EEG. Carotid blood flow implies the presence of cerebral circulation, and hence the presence of some viable tissue. The absence of carotid blood flow does not help diagnosis either due to the presence of the vertebral system. Cremasteric reflexes are spinal reflexes (and not brainstem reflexes), and their presence does not exclude the diagnosis. Elevated serum aminoglycoside concentration is nonspecific, and has little bearing. Cerebral edema does not rule out brain death.