0000000000684538
AUTHOR
Andre Reuland
CT Angiography as a Confirmatory Test in Brain Death
Objective: From recent studies, it remains unclear whether CT angiography could be an alternative to other established ancillary tests for the diagnosis of brain death. We examined intracranial contrast enhancement in CT angiography after clinically established brain death and compared the results with EEG and TCD findings.
Contrast-enhanced transcranial Doppler ultrasonography in the diagnosis of brain death
The diagnosis of brain death (BD) is based on clinical criteria including deep coma, brain stem areflexia and apnoea. Depending on different local guidelines, confirmatory technical tests are sometimes mandatory.1 Since the 1990s, transcranial Doppler sonography (TCD) has found its place in these circumstances and fulfils most of the criteria of an ‘ideal test’ in confirming BD. To confirm intracranial circulatory arrest (CA) with Doppler sonography, typical flow patterns must be recorded in bilateral intracranial and extracranial brain-supplying arteries.2 A completely absent intracranial flow signal is not a reliable sign to determine CA because this can be due to transmission problems. I…
Detection of intracranial circulatory arrest in brain death using cranial CT-angiography.
Background and purpose Computed tomographic-angiography (CT-A) is becoming more accepted in detecting intracranial circulatory arrest in brain death (BD). An international consensus about the use and the parameters of this technique is currently not established. We examined intracranial contrast enhancement in CT-A after clinically confirmed BD, compared the results with electroencephalography (EEG) and Transcranial Doppler Ultrasonography (TCD) findings and developed a commonly applicable CT-A protocol. Methods Prospective, monocentric study between April 2008 and October 2011. EEG, TCD and CT-A were performed in 63 patients aged between 18 and 88 years (mean, 55 years) who fulfilled clini…