Table 4.

Published cases of reversibility of at least one absent brainstem function occurring after the diagnosis of brain death

Reference	Age	Apnea test done	EEG result	CBF result	Brain Imaging result	Details of the case
Kohrman et al, 1990 [171]	3 months	Yes	ECS	Present on day 6, after the BD diagnosis	Diffuse cerebral edema	Found apneic in crib, requiring CPR. On day 4 and 24 hours later fulfilled BD criteria. Four hours after the second exam developed sucking movements. Over the next 3 days regained eye opening, facial grimacing, eye movements, and corneal reflexes for 30 days until death.
Haun et al, 1991 [88]	3 months	Yes	ECS	Not done	Normal on presentation	Found unresponsive between bed and wall requiring CPR. On day 4 and 24 hours later fulfilled BD criteria. Eight minutes after extubation had spontaneous regular breathing.
Okamato et al, 1995 [172]	3 months	Yes	ECS	Present on day 19, after the BD diagnosis	Severe atrophy on day 19	Hypoglycemia and apnea requiring CPR. On day 3 and 5 fulfilled BD criteria. Regained spontaneous respirations on day 43 until death on day 71.
Shewmon, 2018 [173]	2 years	Stopped at PaCO2 58 mmHg due to desaturation	Likely ECS	CPP zero for several hours. Absent DPTA flow.	Massive cerebral edema with herniation	Severe TBI. Diagnosed BD at 72 hours: met all criteria for BD (ancillary CBF test done because apnea test could not be completed). After extubation had spontaneous breathing.
Roberts et al, 2010 [174]	26 years	Yes	Not done	Present on MRI in MCA, after the BD diagnosis	Uncal and tonsillar herniation with generalized cerebral edema	Mastoiditis and temporal lobe abscess, with normal otoscopy. At 7 hours fulfilled BD criteria. In operating room at 28 hours regained spontaneous breathing.
Webb et al, 2011 [175]	55 years	Yes	ECS	Absent at hour 200, after the BD diagnosis	Diffuse cerebral edema	Cardiac arrest, cooled to <35 degrees for up to 10 hours until hour 55. At hour 72 and 78 met all criteria for BD. In operating room at hour 98 had cough, corneal reflexes, and spontaneous breathing.
Latorre et al, 2020 [176]	59 years	No, due to hemodynamic instability	Not done	Absent on SPECT	Intracerebral hemorrhage, cerebral edema, transtentorial and tonsillar brain herniation	Catastrophic spontaneous intracerebral hemorrhage. Clinical exam at 51 hours compatible with BD, but no apnea test done. Tc-99m Bicisate SPECT scan at 52 hours confirmed absent uptake. “The following morning” he had “cough, intermittent spontaneous respirations, and extensor posturing of the right arm and leg to noxious stimulation.”

BD brain death, CBF cerebral blood flow, CPP cerebral perfusion pressure, CPR cardiopulmonary resuscitation, ECS electrocerebral silence, EEG electroencephalogram, MCA middle cerebral artery, TBI traumatic brain injury