A 64-Year-Old Man Is Found Unresponsive, Pulseless, and with Asystole

A 64-year-old man is found unresponsive, pulseless, and with asystole when the ambulance arrives.  He is intubated, resuscitated, and transferred to the hospital.  Initial workup is consistent with subarachnoid bleeding.  The patient has a history of coronary artery disease, multiple percutaneous coronary interventions, and congestive heart failure with low left ventricular ejection fraction.  On repeat evaluation 24 hours later, he is comatose and does not respond to any verbal stimuli.  The patient's temperature is 36.7 C (98.1 F) , blood pressure is 123/82 mm Hg, and pulse is 78/min.  Pupils are dilated and fixed at 8 mm.  Which of the following findings would most likely suggest brain death in this patient?

A) Absent cough reflex on tracheal suctioning
B) Babinski sign present bilaterally
C) Flexion of the toes on foot percussion
D) Knee flexion on foot stimulation
E) Preserved superficial abdominal reflexes

Correct Answer:

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