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Neurocritical Care

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01-10-2012 | Neuroimage

Plantar Flexion with Noxious Dorsal Foot Stimulation in Brain Death

Authors: Amanda L. Hernandez, Nicholas A. Blondin, Gioacchino Curiale, David M. Greer

Published in: Neurocritical Care | Issue 2/2012

Abstract

Background

Plantar flexion with plantar stimulation has been well described in brain death, and is compatible with brain death. However, plantar flexion with stimulation to the dorsal surface of the foot has not been reported previously in brain dead patients.

Methods

Case report with Technetium-99 m hexamethylpropyleneamine oxime brain scan and video.

Results

A 46-year-old woman suffered severe anoxic brain injury following massive pulmonary embolism 5 days after arthroscopic knee surgery. Neurologic examination was consistent with brain death, with the exception of plantar flexion when noxious stimulation was applied to the dorsal surface of the great toe on each side. Ancillary testing with a technetium-99 m nuclear scan demonstrated absence of cerebral perfusion, supporting the diagnosis of brain death.

Conclusions

Noxious stimulation to the dorsal surface of the foot may trigger spinally mediated plantar flexion in patients with brain death.

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Title: Plantar Flexion with Noxious Dorsal Foot Stimulation in Brain Death
Authors: Amanda L. Hernandez
Nicholas A. Blondin
Gioacchino Curiale
David M. Greer
Publication date: 01-10-2012
Publisher: Humana Press Inc
Published in: Neurocritical Care / Issue 2/2012
Print ISSN: 1541-6933
Electronic ISSN: 1556-0961
DOI: https://doi.org/10.1007/s12028-012-9697-x

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Plantar Flexion with Noxious Dorsal Foot Stimulation in Brain Death

Abstract

Background

Methods

Results

Conclusions

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

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