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At first glance, the question “can we see the living brain?” sounds somewhat strange. Of course we can see the living brain, neurosurgeons see it every day. But if we look closer and beyond the “neurosurgical” superficial macroscopic view of the brain, the more correct questions arise “How to define the living brain versus brain death?” and “Which brain structures are we able to visualize in vivo?” Before we proceed into details of visualization I would like to define “living” or “life” in a medical context. Which organ is decisive for life? Already as early as 2,500 years ago this question was answered in a different way. Aristotle who made vivisections of animals was sure that the throbbing heart which pumps warm blood in all parts of the body would be the center of life whereas the greyish cold brain would have only the task of cooling the hot blood. Hippocrates by contrast, put the brain in the center of human vitality by defining “κατα ταυτα νομιζω τον εγκεφαλον δυναμιν εχειν πλειστην εν τω ανθρωπω” (after all I judge the brain to have the most power in man). However, Aristotle won this dispute. Until the second half of the 20th century, life ended with the last beat of the heart, a consequent and clear-cut definition of life and death. And still, in our daily emotional life, the heart and not the brain plays the central role. So still today, we are used to feel “from the bottom of our heart” and never “from the bottom of our brain”. From a medical perspective, the definition of death by using a conception of brain death became only important when in transplantation medicine living organs including the heart were necessary for transplantation while the death of the individual was now to be defined as the death of his or her brain. In 1968, an ad hoc committee at Harvard Medical School advanced new criteria for determining death. It proposed that patients in irreversible coma with no discernible central nervous system activity were actually dead. But even to date, almost fifty years later and with all our sophisticated technical investigations, the “true” definition of brain death remains tricky. The Uniform Determination of Death Act (UDDA) is a draft state law that was approved for the United States in 1981 by the National Conference of Commissioners on Uniform State Laws, in cooperation with the American Medical Association, the American Bar Association, and the President’s Commission for the Study of Ethical Problems in Medicine and Biomedical and Behavioral Research. By the definition of UDDA, an individual who has sustained either (1) irreversible cessation of circulatory and respiratory functions, or (2) irreversible cessation of all functions of the entire brain, including the brain stem (“whole brain” definition), is dead. A determination of death must be made in accordance with accepted medical standards. But the U.S. law differs substantially from all other brain death legislation in the world because the U.S. law does not spell out details of the neurologic examination and accepted medical standards [1]. Review Article

Can we see the living brain? A review on in vivo visualization of the brain