LAUSR

In “Infratentorial Brain Injury Among Patients Suspected of Death by Neurologic Criteria: A Systematic Review and Meta-analysis,” Briard et al. report that based on a review of 21 studies, the prevalence of (1) infratentorial brain injury among patients with suspected death by neurologic criteria (DNC) was 2%–16% and (2) isolated brainstem death was 1%–4%. Machado pointed out that a series of 4 patients with infratentorial brain injury who initially had isolated brainstem death subsequently progressed to whole-brain death. The study on these patients was included in Briard's review. He also commented that Jahi McMath, who was declared dead by neurologic criteria based on both clinical evaluation and ancillary testing after hypoxic-ischemic brain injury, had a lesion in her pons and was not dead by neurologic criteria because she did not have a complete intracranial circulatory arrest. This case has been discussed extensively in the literature, but Briard and Chassé did not offer comments on it. However, they agree with Machado that additional research is needed to understand the determination of DNC in patients with infratentorial brain injury.