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Forensic Medicine · Thanatology: respirator brain
Sample itemA man kept on a ventilator for several days after brain stem death is autopsied. The brain is soft and friable and disintegrates when removed, although the rest of the body shows no decomposition. What is this finding?
Original practice item, not a recalled exam question. Nothing here is recorded.
The answer and the reasoning
C. Respirator brain from autolysis without perfusion
When intracranial pressure exceeds perfusion pressure after brain death, blood flow to the brain stops while the rest of the body is kept oxygenated. The brain then undergoes autolysis and becomes soft and liquefied, termed respirator brain. The body shows no general putrefaction.
Option by option
A. Contusional necrosis after head injury
Contusional necrosis is focal and linked to the site of impact.
B. Cerebral abscess with liquefaction
An abscess would be a focal, encapsulated pus collection, not a diffuse softening.
C. Respirator brain from autolysis without perfusion (correct)
Correct. Absent cerebral perfusion allows autolysis in an otherwise preserved body.
D. Early putrefaction of the brain
Putrefaction would show in the whole body, with green discolouration and gas, which is absent.
Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.
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