engleski

Role of Diagnostic Imaging Methods in Confirmation of Brain death

Learning Objectives: To show how ancillary tests can be crucial in quick determination of brain death (BD) especially in relation to organ transplant where time is of the essence. Since Croatia has been among leading countries in the world in number of organ transplants per capita we also want to encourage discussion on methods for BD determination since the methods have not been uniformly defined. Background: With regards to confirmatory tests legislation ranges from not necessary to obligatory. In Croatia confirmatory tests are obligatory and currently 6 ancillary tests (TCD, DSA, MSCTA, EEG, Tc-HMPAO, Evoked potentials) are equally accredited. We conducted a retrospective study of patients diagnosed with BD in year 2012 in our hospital. Imaging Findings: In our hospital TCD, DSA , MSCTA and evoked potentials were used to demonstrate BD. TCD was preferred due to bedside evaluation. In 31 out of 36 patients clinical diagnosis of BD was confirmed with ancillary test. TCD was positive in 13, MSCTA in 9, evoked potentials in 6 and DSA in 3 patients. MSCTA was repeated twice in three and three times in one patient. In 3 out of 11 patients, who underwent MSCTA, BD could not be confirmed because of residual brain flow. Two patients died during the observational period. Conclusion: Although most countries agree upon the definition of BD, there is a discrepancy between the means by which it is determined. We find that confirmatory tests help in diagnosis and also shorten the time in which BD is established.

Diagnostic Imaging; Brain death

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