20 May 2010
Computed Tomographic Angiography in the diagnosis of brain death
Marcin Sawicki, Anna Walecka, Romuald Bohatyrewicz, Wojciech Poncyljusz, Janusz KordowskiMed Sci Monit 2010; 16(1): 28-32 :: ID: 880579
Abstract
Two neurophysiological methods can demonstrate the cessation of brain function: electroencephalography (EEG) and brain-stem auditory-evoked potentials. Conventional angiography of the 4 cerebral arterial axes are the reference standard for imaging brain death. Thus, it is an invasive examination that needs an experienced neuroradiologist, and the availability of an angiography suite. The use of a computed tomographic (CT) scan to diagnose brain death (BD) was proposed in 1978. This examination developed widely these last years thanks to a new generation of multirow CT, which allows visualization of opacified cerebral vessels. This study sought to determine the accuracy of CT, for confirmation of BD.
We examined 15 patients with suspicion of BD according to clinical criteria defined by law. CT scan was performed with and without injection of contrast material, followed by cerebral angiography. In our material, CT angiography showed opacification of A2-ACA and M2 or M3-MCA in 10 patients. In our patients, results of CT angiography fulfill the criteria proposed by the French Society of Neuroradiology: absence of perfusion of M4 middle cerebral artery segments (M4-MCA) and deep cerebral veins. In conventional angiography, 2 patients showed, at the level of the anterior and middle cerebral artery, a phenomenon already described as stasis filling.
CT angiography is a promising radiologic examination in diagnosing BD. When confirmatory examinations are required among BD patients for whom the clinical diagnosis remains essential, it may be an interesting alternative to conventional cerebral angiography, which is more invasive and constraining, and when EEG is unavailable or inadequate.
Keywords: Brain Death, conventional angiography, CT, Angiography
Editorial
01 April 2024 : Editorial
Editorial: Forty Years of Waiting for Prevention and Cure of HIV Infection – Ongoing Challenges and Hopes for Vaccine Development and Overcoming Antiretroviral Drug ResistanceDOI: 10.12659/MSM.944600
Med Sci Monit 2024; 30:e944600
In Press
07 Mar 2024 : Clinical Research
Knowledge of and Attitudes Toward Clinical Trials: A Questionnaire-Based Study of 179 Male Third- and Fourt...Med Sci Monit In Press; DOI: 10.12659/MSM.943468
08 Mar 2024 : Animal Research
Modification of Experimental Model of Necrotizing Enterocolitis (NEC) in Rat Pups by Single Exposure to Hyp...Med Sci Monit In Press; DOI: 10.12659/MSM.943443
18 Apr 2024 : Clinical Research
Comparative Analysis of Open and Closed Sphincterotomy for the Treatment of Chronic Anal Fissure: Safety an...Med Sci Monit In Press; DOI: 10.12659/MSM.944127
08 Mar 2024 : Laboratory Research
Evaluation of Retentive Strength of 50 Endodontically-Treated Single-Rooted Mandibular Second Premolars Res...Med Sci Monit In Press; DOI: 10.12659/MSM.944110
Most Viewed Current Articles
17 Jan 2024 : Review article
Vaccination Guidelines for Pregnant Women: Addressing COVID-19 and the Omicron VariantDOI :10.12659/MSM.942799
Med Sci Monit 2024; 30:e942799
14 Dec 2022 : Clinical Research
Prevalence and Variability of Allergen-Specific Immunoglobulin E in Patients with Elevated Tryptase LevelsDOI :10.12659/MSM.937990
Med Sci Monit 2022; 28:e937990
16 May 2023 : Clinical Research
Electrophysiological Testing for an Auditory Processing Disorder and Reading Performance in 54 School Stude...DOI :10.12659/MSM.940387
Med Sci Monit 2023; 29:e940387
01 Jan 2022 : Editorial
Editorial: Current Status of Oral Antiviral Drug Treatments for SARS-CoV-2 Infection in Non-Hospitalized Pa...DOI :10.12659/MSM.935952
Med Sci Monit 2022; 28:e935952