Possibly Silly Neurology Question / Pam Reynolds Case

[INRM]

I remember there was a case of a then 35 year old woman who had a Baslilar artery aneurysm which required a unique medical proceedure to fix it called a hypothermic cardiac arrest.

Despite this she had a near-death experience. Now many people have proposed, and possibly correctly, that the NDE happened before and/or after her brain-activity was flat-lined for the proceedure to work.

Assuming it was not true... how can this be explained?

BTW: There are cells in the brains of certain organisms that can detect magnetic fields for navigation -- if all those cells are alive, but not transmitting yet all are receiving some kind of signal -- say a given magnetic field.. they would all sense it right?

INRM

[INRM]

Nobody have an answer to either one?

INRM

[JoeTheJuggler]

I remember there was a case of a then 35 year old woman who had a Baslilar artery aneurysm which required a unique medical proceedure to fix it called a hypothermic cardiac arrest.

Despite this she had a near-death experience. Now many people have proposed, and possibly correctly, that the NDE happened before and/or after her brain-activity was flat-lined for the proceedure to work.

Assuming it was not true... how can this be explained?

Why make such an assumption?

By the way, is there any evidence that her brain activity was flat-lined for the procedure? Stopping the heart does not equal no brain activity.

ETA: did this procedure involve having her attached to an EEG machine?

[Phil]

There was a good thread about the Pam Reynolds case here a couple years ago, but I can't seem to find it.

[kellyb]

Now many people have proposed, and possibly correctly, that the NDE happened before and/or after her brain-activity was flat-lined for the proceedure to work.

Assuming it was not true... how can this be explained?

I'm not sure what there is to not understand about that possibility.
She might have had a hallucination going into or coming out of complete unconsciousness.
There's also a chance that EEGs don't pick up small amounts of brain activity happening deep in the brain, I think. So who knows?

[AgeGap]

During fast jet training, pilots are trained to withstand high(ish) g-forces. At high g, blood drains from the brain and you get tunnel vision. I am sure it has been reported that before blacking out, the pilots can have a sort of NDE. They lose all peripheral vision and they describe looking down a long tunnel with a bright light at the end.

[Professor Yaffle]

How on earth do you establish at what time a NDE occurred and whether this coincided with lack of brain activity. Did the person having the NDE happen to look at the clock when having this experience, and if so why can't we assume that the time they saw was as much of a hallucination as the NDE was??

[casebro]

During fast jet training, pilots are trained to withstand high(ish) g-forces. At high g, blood drains from the brain and you get tunnel vision. I am sure it has been reported that before blacking out, the pilots can have a sort of NDE. They lose all peripheral vision and they describe looking down a long tunnel with a bright light at the end.

Gee, that's a new approach to NDE's. They are nothing but tunnel vision. As the eyes lose circulation, visual field narrows, focus goes out the window, all you see of the world is a small bright blob. A glowing Orb, anyone?

As I was being anesthetized on time, the surgeon started talking about religion. At the time I thought it was odd. I wonder if he was trying to implant a concept into my susceptible mind? Trying to get me thinking of GOD? Programming me for a possible Religious Experience? It didn't work, I'm too skeptical.

[fls]

How on earth do you establish at what time a NDE occurred and whether this coincided with lack of brain activity. Did the person having the NDE happen to look at the clock when having this experience, and if so why can't we assume that the time they saw was as much of a hallucination as the NDE was??

I think it's based on reporting on overheard conversations.

For example, with Pam Reynolds, she reported on a remark that likely was made by one of the doctors present. However, she was not brain dead at that point - just sedated with barbituates. The claim is that speakers she was wearing over her ears (for testing of auditory evoked potentials) eliminated the possibility of physical hearing, but I doubt the veracity of that statement. It seems to me that that would only eliminate (or maybe just reduce) air conduction, but would not influence bone conduction.

Linda

[INRM]

Kelly B,

Would EEG's have trouble determining activity deep inside the brain-stem, particularly the upper area of it,


fls,

Are you sure? According to what I heard she was completely flat-lined at that point when they said something about her veins being too small. Maybe I'm wrong though. What's your source?

They used clicks or beeps to determine if the brain-stem was out for testing. Wouldn't the same vibratious also affect bone conduction as well? How would bone conduction be carried out differently?

INRM

[fls]

fls,

Are you sure? According to what I heard she was completely flat-lined at that point when they said something about her veins being too small. Maybe I'm wrong though.

She couldn't have been. The procedure (during which the veins comment was made) was to prepare her for brain death and necessarily must have taken place before she was flat-lined.

What's your source?

"Light and Death" by Michael Sabom.

They used clicks or beeps to determine if the brain-stem was out for testing. Wouldn't the same vibratious also affect bone conduction as well? How would bone conduction be carried out differently?

I'm saying that part of what we hear is through bone conduction, so reducing air conduction does not eliminate our ability to hear.

Linda

[INRM]

FLS,

Light and Death was a good source... Sabom is an expert in his field.

Either way though, what I'm getting at is even though the beeps and clicks used to measure brain activity -- wouldn't bone conduction be included as well?

Also... the other part that struck me as weird as before she was brought back she had some kind of bizarre experience. Like as if she was being forced to jump into her body which felt like a pool of water or something -- Weird (IMHO)

They had trouble restarting her heart IIRC. When did she have that last experience compared to when they got her heart up and running?


INRM

[fls]

FLS,

Light and Death was a good source... Sabom is an expert in his field.

Either way though, what I'm getting at is even though the beeps and clicks used to measure brain activity -- wouldn't bone conduction be included as well?

Yes, bone conduction would be included in the beeps and clicks used to measure brain activity. This point is completely irrelevant to my point, though. The claim was that she couldn't have overheard the conversation through normal means and my point is that normal means of hearing weren't eliminated.

Also... the other part that struck me as weird as before she was brought back she had some kind of bizarre experience. Like as if she was being forced to jump into her body which felt like a pool of water or something -- Weird (IMHO)

Were you expecting something different? Personally, I wouldn't know what to expect. I've had some really weird feelings, and that was in the absence of being brain dead.

They had trouble restarting her heart IIRC. When did she have that last experience compared to when they got her heart up and running?

What experience are you referring to? The overheard conversation would have been before her heart was stopped in the first place.

Linda

[INRM]

fls,

Well if she had brain-stem activity, and activity in other parts and was just under normal anaesthesia, it's possible she could have just heard the statement outright.

But, from what I remember there was one thing she saw when she was technically brain-dead. And from what I remember the clicks and beeps already registered no brain activity. There was this drill that she was able to describe it's appearance and it was only removed from sterile environment prior to drilling.

Even though those beeps and clicks were to measure brainstem response read nothing, and even though the EEG read flat... is it possible that she still had some activity deep inside: 1.) The brainstem, 2.) The cerebrum, 3.) The cerebellum ?

I'm not sure here. I do have some reason to speculate though since she did say she saw/heard the drilling, but then after that had a typical NDE. Maybe the last bit of brain activity they didn't detect started to fade off?

Or were the instruments accurate enough that they could have determined if there was no activity at the brainstem (particularly the TOP).


INRM

[DouglasL]

It is my understanding that during almost any surgery the eye lids are taped shut. This would eliminate "tunnel vision" from the list of possibilities. Can anyone confirm the taping of the eyes?

[fls]

fls,

Well if she had brain-stem activity, and activity in other parts and was just under normal anaesthesia, it's possible she could have just heard the statement outright.

I agree.

But, from what I remember there was one thing she saw when she was technically brain-dead. And from what I remember the clicks and beeps already registered no brain activity. There was this drill that she was able to describe it's appearance and it was only removed from sterile environment prior to drilling.

The registering of no brain activity from the clicks and beeps was well after the drill was used. When the drill was used she was under general anaesthesia but the procedure that was to lead to brain death had not yet been initiated.

Even though those beeps and clicks were to measure brainstem response read nothing, and even though the EEG read flat... is it possible that she still had some activity deep inside: 1.) The brainstem, 2.) The cerebrum, 3.) The cerebellum ?

I'm not sure here. I do have some reason to speculate though since she did say she saw/heard the drilling, but then after that had a typical NDE. Maybe the last bit of brain activity they didn't detect started to fade off?

Or were the instruments accurate enough that they could have determined if there was no activity at the brainstem (particularly the TOP).

It may be possible, but it doesn't really matter in this case, as the specific events she reported on did not happen during the period of time her EEG was flat. The timing wasn't even close.

Linda

[fls]

It is my understanding that during almost any surgery the eye lids are taped shut. This would eliminate "tunnel vision" from the list of possibilities. Can anyone confirm the taping of the eyes?

It does say her eyes were taped shut. How does that eliminate tunnel vision?

Linda

[INRM]

fls,

Are you sure they did not induce brain-daeath when she was having her skull drilled through? When was brain-death induced...

Did she have or report any kind of sensation during that time period?


INRM

[Jeff Corkern]

I remember there was a case of a then 35 year old woman who had a Baslilar artery aneurysm which required a unique medical proceedure to fix it called a hypothermic cardiac arrest.

Despite this she had a near-death experience. Now many people have proposed, and possibly correctly, that the NDE happened before and/or after her brain-activity was flat-lined for the proceedure to work.

Assuming it was not true... how can this be explained?
INRM

In too many ways, I think.

Because this was not a proper experiment, with proper controls. Which makes sense, because they weren't investigating NDE's, they were trying to fix her aneurysm.

You could theorize all day, but in the end you're not going to be able to answer this one.

[fls]

fls,

Are you sure they did not induce brain-daeath when she was having her skull drilled through?

Yes. They gave her general-anaesthesia, opened the skull and exposed the aneurysm, put her on bypass and cooled the body, then stopped the bypass machine and drained the blood from her brain (by tilting the table upright) until the EEG (which had been responding to the beeps and clicks up to that point) showed no further responses.

Pam stated that she heard the comment about small arteries and veins when she heard the drill (used when the skull was opened). The surgical records show that the exposure of the femoral arteries/veins occurred "simultaneously" with the opening of the skull, and the conversation about the size of the veins and whether both sides would need to be used took place at that time. The femoral arteries and veins were used to hook Pam up to the bypass machine, therefore, if they were still in the process of exposing the vessels, she could not yet have been hooked up to bypass. It takes a while - not something that happens within the space of a few minutes. And it would only make sense for the conversation to take place before she was prepared for bypass, not once they started to prepare her for bypass (since the conversation was about which arteries and veins should be used to accept the tubes for bypass).

Also, in any operation, the time on bypass and the duration of brain death would be kept to a minimum. All the parts of the operation that do not depend upon either (such as opening the skull and exposing the aneurysm) would be completed well before bypass and brain death so that precious time wouldn't be wasted on those procedures.

When was brain-death induced...

The skull was opened at 8:40 a.m. (the femoral arteries/veins were exposed at that time as well). At 10:50 a.m. the aneurysm had been exposed and the decision made to proceed with bypass (the tubes were inserted into her arteries and veins at that point) and brain death (through cooling). At 11:20 a.m. the body was cooled to the point where no activity registered on the EEG. At 11:25 a.m. the bypass machine was stopped and blood was drained from the brain.

Did she have or report any kind of sensation during that time period?

The report that could be tied to a specific event and confirmed happened around 8:40 a.m. The rest of her report is non-specific, provides no cues to timing, and is unrelated to the actual operation or actual events (traveling down a tunnel, meeting family members, a sensation of sparkles, etc.). The next specific thing she reports is Hotel California playing while she awakens from general anaesthesia at around 2:10 p.m.

Linda

[INRM]

So, it's likely the NDE occured before and after the brain-death occured?

Is it possible that at the moment of standstill some residual actiivity could have evaded detection just hypothetically? Particularly from the brainstem or parts deep-inside the brain (with the brainstem shut-down and reduced blood-flow)? Also was it possible for a small amount of pooling of blood deepinside the brain (in vessels of course) that wasn't noticed?

Was "Hotel California" playing when she was awakened?


INRM

[fls]

So, it's likely the NDE occured before and after the brain-death occured?

Is it possible that at the moment of standstill some residual actiivity could have evaded detection just hypothetically? Particularly from the brainstem or parts deep-inside the brain (with the brainstem shut-down and reduced blood-flow)? Also was it possible for a small amount of pooling of blood deepinside the brain (in vessels of course) that wasn't noticed?

What difference would it make?

Was "Hotel California" playing when she was awakened?

INRM

It doesn't say.

Linda

[INRM]

FLS,

Uh, it would satisfy my curiousity? (The difference it would make)


INRM