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Brain Death Criteria-Reply

THOMAS W. ROWLAND, MD; JOSEPH H. DONNELLY, MD; ANTHONY H. JACKSON, MD; SUSAN B. JAMROZ, RN
Am J Dis Child. 1984;138(1):102-103. doi:10.1001/archpedi.1984.02140390084030.
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In Reply.—Belsh's comments regarding our article1 are appreciated. We certainly agree that one must attempt to determine the cause for cessation of cerebral function before declaring brain death. This issue indeed was considered in our patients (criteria 4 and 5 and later on in the "Conclusions" section). Belsh also insists that there is a need for further confirmatory studies, other than an observation period and meeting the criteria set forth in our article. The major point of our article is that if 72 hours is taken as a period of observation with no change in the clinical examination during that period of time, the EEG and other studies may well be unnecessary. This becomes particularly important for patients hospitalized in centers where the technical and interpretive expertise in EEG studies is not readily available; one must also be concerned about the fact that angiographic and isotopic studies may, according

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