Diagnosis of brain death

Brain death (BD), or death by neurological criteria (DNC), defined as the irreversible cessation of all cerebral and brainstem activities, has been a medically and legally accepted formulation of death. This review article summarizes the clinical criteria and diagnostic protocols for determining brain death. Emphasis is placed on the integration of clinical examination findings, such as the absence of brainstem reflexes and apnea testing, alongside ancillary tests when required. Key guidelines are discussed to ensure a standardized and legally sound diagnosis, including approaches to confounding factors such as drug intoxication, metabolic disturbances, or hypothermia. Furthermore, the article highlights advancements in imaging techniques and electrophysiological monitoring that supplement traditional assessments. This review aims to provide a comprehensive understanding of brain death diagnosis, ensuring accuracy and consistency in clinical and legal practices worldwide.