{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T17:40:59Z","timestamp":1792086059985,"version":"4.4.0"},"reference-count":39,"publisher":"Oxford University Press (OUP)","issue":"1","license":[{"start":{"date-parts":[[2022,12,15]],"date-time":"2022-12-15T00:00:00Z","timestamp":1671062400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2022,12,19]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:p>Brain death (death by neurologic criteria) is declared in 2% of all in-hospital deaths in the United States. Published neuropathology studies of individuals maintained on cardiorespiratory support are generally decades old, and notably include only 3 cases with long intervals between brain and \u201csomatic\u201d death (68\u2009days, 101\u2009days, 20\u2009years). Here, we share our observations in a young woman supported for nearly 4\u00bd years following declaration of brain death after oropharyngeal surgery. While limited by tissue availability and condition, we found evidence of at least partial perfusion of the superficial cerebral and cerebellar cortices by external carotid and vertebral arteries (via meningeal and posterior pharyngeal branches), characterized by focal cellular reaction and organization. Dural venous sinuses had thrombosis and recanalization, as well as iron deposition. In nonperfused brain areas, tissue \u201cmummification,\u201d akin to that seen in certain postmortem conditions, including macerated stillbirths and saponification (adipocere formation), was identified, and are reviewed herein. Unfortunately, correlation with years-earlier clinical and radiographic observations was not possible. Nevertheless, we feel that our careful neuropathologic inspection of this case expands the understanding of the spectrum of human brain tissue alterations possible in a very rarely seen set of conditions.<\/jats:p>","DOI":"10.1093\/jnen\/nlac090","type":"journal-article","created":{"date-parts":[[2022,12,15]],"date-time":"2022-12-15T21:55:51Z","timestamp":1671141351000},"page":"6-20","source":"Crossref","is-referenced-by-count":5,"title":["Neuropathologic findings in a young woman 4\u00a0years following declaration of brain death: case analysis and literature review"],"prefix":"10.1093","volume":"82","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3858-7949","authenticated-orcid":false,"given":"Rebecca D","family":"Folkerth","sequence":"first","affiliation":[{"name":"From the New York University Grossman School of Medicine, New York City Office of Chief Medical Examiner, New York, New York, USA (RDF); Departments of Pathology, Neuroscience and Artificial Intelligence & Human Health, Ronald M. Loeb Center for Alzheimer's Disease, Neuropathology Brain Bank & Research Core, Friedman Brain Institute, Icahn School of Medicine at Mount Sinai, New York, New York, USA (JFC); and Departments of Pediatrics and Neurology, David Geffen School of Medicine at UCLA , Los Angeles, California, USA (DAS)"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John F","family":"Crary","sequence":"additional","affiliation":[{"name":"From the New York University Grossman School of Medicine, New York City Office of Chief Medical Examiner, New York, New York, USA (RDF); Departments of Pathology, Neuroscience and Artificial Intelligence & Human Health, Ronald M. Loeb Center for Alzheimer's Disease, Neuropathology Brain Bank & Research Core, Friedman Brain Institute, Icahn School of Medicine at Mount Sinai, New York, New York, USA (JFC); and Departments of Pediatrics and Neurology, David Geffen School of Medicine at UCLA , Los Angeles, California, USA (DAS)"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"D Alan","family":"Shewmon","sequence":"additional","affiliation":[{"name":"From the New York University Grossman School of Medicine, New York City Office of Chief Medical Examiner, New York, New York, USA (RDF); Departments of Pathology, Neuroscience and Artificial Intelligence & Human Health, Ronald M. Loeb Center for Alzheimer's Disease, Neuropathology Brain Bank & Research Core, Friedman Brain Institute, Icahn School of Medicine at Mount Sinai, New York, New York, USA (JFC); and Departments of Pediatrics and Neurology, David Geffen School of Medicine at UCLA , Los Angeles, California, USA (DAS)"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2022,12,15]]},"reference":[{"key":"2024032523494449600_nlac090-B1","doi-asserted-by":"crossref","first-page":"1078","DOI":"10.1001\/jama.2020.11586","article-title":"Determination of brain death\/death by neurologic criteria: The world brain death project","volume":"324","author":"Greer","year":"2020","journal-title":"JAMA"},{"key":"2024032523494449600_nlac090-B2","doi-asserted-by":"crossref","first-page":"1911","DOI":"10.1212\/WNL.0b013e3181e242a8","article-title":"Evidence-based guideline update: Determining brain death in adults: Report of the Quality Standards Subcommittee of the American Academy of Neurology","volume":"74","author":"Wijdicks","year":"2010","journal-title":"Neurology"},{"key":"2024032523494449600_nlac090-B3","doi-asserted-by":"crossref","first-page":"105885","DOI":"10.1016\/j.clineuro.2020.105885","article-title":"Incidence of brain death in the United States","volume":"195","author":"Seifi","year":"2020","journal-title":"Clin Neurol Neurosurg"},{"key":"2024032523494449600_nlac090-B4","doi-asserted-by":"crossref","first-page":"206","DOI":"10.1002\/ana.410020305","article-title":"Brain death: II. 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