Brain Death: Diagnosis and Imaging Techniques

Publication date: Available online 2 March 2018Source: Seminars in Ultrasound, CT and MRIAuthor(s): Tanvir Rizvi, Prem Batchala, Sugoto MukherjeeBrain death (BD) is an irreversible cessation of functions of the entire brain, including the brainstem. The diagnosis of BD is made on clinical grounds and neurologic examination. In the United States, clinical criteria set by the American Academy of Neurology (AAN) emphasize 3 specific clinical findings to confirm BD, which include coma, absence of brainstem reflexes and apnea. Ancillary tests are needed when neurologic examination or apnea test cannot be performed. AAN recommended ancillary tests include electroencephalogram, which confirms electrical activity loss; catheter cerebral angiogram, which confirms loss of cerebral blood flow; as well as transcranial Doppler and nuclear scintigraphy. Digital subtraction angiography remains the gold standard for confirmation of lack of cerebral blood flow. On 99m Techentium hexa methyl propylene amine oxime or 99mTechnetium-ethylene cysteine diethyl ester (99mTc-ethylene cysteine diethyl ester) Nuclear scintigraphy, lack of intracranial radiotracer uptake, correlates with BD. Although imaging studies like computed tomography angiogram (CTA), MR angiogram, CT perfusion, and MR perfusion are frequently used, they are currently not recommended by AAN. However, they hold tremendous promise in future as imaging tools in the armamentarium of a radiologist investigating BD as adjunct imaging to...
Source: Seminars in Ultrasound, CT and MRI - Category: Radiology Source Type: research