engleski

Consensus opinion on diagnosing brain death – Guidelines for application of confirmatory tests Report of Croatian Neurovascular Society and University departement of neurology, University hospital «Sestre milosrdnice», Referral Centar for Neurovascular Disorders of Ministry of Health of Republic Croatia

Brain death is defined as the irreversible loss of all brain functions, including the brainstem. The diagnosis of brain death allows organ donation or withdrawal of support. Therefore the exact criteria for the diagnose must be determined. In Croatian transplant law, repeated neurological examination must show loss of brainstem reflexes, and one confirmation test must be done. Several tests are available, showing the cessation of brain or brainstem activity or confirming the cerebral circulatory arrest. Bedside evaluation is possible through electrencephysiologic and neurosonological tests. Conventional or digital subtractional angiography is done in the radiology suite, and isotope angiography and technetium-99m hexamethylpropyleneamineoxime (99Tc-HMPAO) at the Department for nuclear medicine. Such tests require special settings, therefore bedside test like electroencephalography, evoked potentials and neurosonology tests are preferred. All tests require trained personel and strict protocols, which differ of the routine investigation. The confirmatory tests applied in brain death confirmation are presented, the techniques, criteria, results and validity of the tests.

brain death ; confirmatory test ; transcranial doppler ; Croatian law

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