Dear Prof. Giovanni Maria Vian, Director of the ‘Osservatore Romano’,

I have been interested in the subject of BRAIN DEATH since 1969 (Italian Hospitals - Surgery, 5, 1969, XX) soon after Barnard’s first transplant, and therefore I forward for your attention my paper which is entitled “Experimental demonstration of the pathogenesis of coma through the collapse of the Unified Synaptic Canal - Physiological and clinical considerations”. This work is published by Minerva Medica (Gazz. Medica Italiana, 3, 166, 6,2007) and is soon to be published in English.

In the debate resulting from Lucetta Scaraffia’s interesting article about ‘brain death’ the subject of more or less reversible coma was discussed but coma, which is a symptom and not a diagnosis, was neither defined nor explained during the debate. The Unified Synaptic Canal, which is the centre of the formation and identification of consciousness, collapses in cases of haematoma following cranial-cerebral trauma; due to the compression caused by the haematoma the consciousness, which circulates in the interneuronic canal, is cut off. The 150-200 billion neurons (which make up the grey matter of the cortical layer), cells which are fundamental units of the central nervous system and which create consciousness, then cease to function. Therefore the loss of consciousness is identified with coma. The patient sleeps. Etymologically the word coma comes from the Greek - Cώma= deep sleep.

My conclusions in this paper are in clinical and therapeutic order.
In short, the phrase “90 minutes to save the brain” highlights how VERY EARLY TUBULAR MULTIPLE DRAINAGE of the cranial cavity, or an evacuating craniotomy if necessary, will reduce the compression of the neuronal cells caused by the haematoma and so avoid the process wich in time leads to irreversible coma, which is caused by the total and persistent collapse of the Unified Synaptic Canal and the cutting off of the neuronal system as previously described.

It would therefore be advisable that neurosurgeons were present in all hospitals -even those on the outskirts - at all times in order to be able to act as soon as possibile as is already the case for myocardial infarction (early angioplasty) and strokes (teams act within 3 hours). If this were so the frequency of so called BRAIN DEATH (determined by questionable government legislative decrees) would be considerably reduced, if not eliminated. Reducing the cases of so called BRAIN DEATH contrasts with the doctrine and interests of explant-transplantology which has unfortunately imposed the concept of “MORS TUA VITA MEA”, which is in contrast with the expression “Unicuique suum”.

Live and vital organs should not be harvested from persons described as corpses, because if they have a beating heart and blood circulation they are not corpses. Drainage therapy should be carried out as soon as possible to avoid a progressive and degenerative process which can be interrupted and from which the patient can wake up.
Please excuse the long Excursus, but the subject is of VITAL importance.


                                                            With regards and best wishes
                                                            I am available for any further explanations.