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Intellectual Death Is Not Brain Death

I cringed when I read the editorial by Murray entitled "Brain Death by a Thousand Hypoxic Cuts in Sleep" (1). This editorial was not about brain death, but about silent brain infarcts that could perhaps lead to cognitive decline, although this was not persuasively shown by the investigators whose article Murray was citing (2).

Brain dead is a colloquial term sometimes used to designate intellectual death, dullness, or even thoughtlessness. However, in an academic journal it should mean what it is, a legal definition of death using neurological criteria (3). I hope this error does not suggest a deeper problem of definition of comatose states with physicians. If so, we as neurointensivists have an immense educational task at hand.

Eelco F. M. Wijdicks

Mayo Clinic, Rochester, Minnesota

FOOTNOTES

Conflict of Interest Statement: The author has no financial relationship with a commercial entity that has an interest in the subject of this manuscript.

REFERENCES

1. Murray BJ. Brain death by a thousand hypoxic cuts in sleep [editorial]. Am J Respir Crit Care Med 2007;175:528–529.[Free Full Text]
2. Minoguchi K, Yokoe T, Tazaki T, Minoguchi H, Oda N, Tanaka A, Yamamoto M, Ohta S, O'Donnell CP, Adachi M. Silent brain infarction and platelet activation in obstructive sleep apnea. Am J Respir Crit Care Med 2007;175:612–617.[Abstract/Free Full Text]
3. Wijdicks EFM. The diagnosis of brain death. N Engl J Med 2001;244:1215–1221.

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