Naslov
Coregistration of transcranial dopplersonography and eeg in the diagnostic procedures of detection of brain death

Autori
Šupe, Svjetlana ; Hajnšek, Sanja ; Starčević, Katarina ; Bujan Kovač, Andreja

Vrsta, podvrsta i kategorija rada
Sažeci sa skupova, sažetak, stručni

Izvornik
Cerebrovasc Dis / - , 2015, 26-27

Skup
20th Meeting of the European Society of Neurosonology and Cerebral Hemodynamics

Mjesto i datum
Zadar, Hrvatska, 7.05.-11.05.2015

Vrsta sudjelovanja
Poster

Vrsta recenzije
Međunarodna recenzija

Ključne riječi
transcranial Doppler-sonography, EEG, criteria, cerebral death

Sažetak
Background: The guidelines for the determination of cerebral circulatory arrest (brain death) include clinical criteria and, depending on countries, some confirmatory testing like TCD, EEG, Evoced potential, CT angiography, brain scintigraphy. Brain death is the process and its confirmation must be done with responsibility and proven reliability, particularly in the situations of planned organ transplantation. In donor management protocol in our practice, after brain stem death determined by clinical examination, we perform EEG and TCD monitoring followed by brain scintigraphy and in exceptional conditions, cerebral angiography as additional diagnostic test for brain death confirmation. Methods: We present a case of patient which fulfilled clinical criteria of brain death due to a massive intracerebral hemorrhage (coma, absence of brainstem reflexes, apnea) in whom we monitored EEG and TCD. Initially, on the first day of clinical proven brain death, brain scintigraphy detected only minimal signs of cerebral flow in sagital venous sinus and cerebral angiography showed minimum sustained flow in the M2 segment of the right MCA. Results: During the nine days of monitoring, persisting EEG activity was obtained on right temporoparietal regions and TCD showed blood flow in right MCA on insonnation thought temporal bone window.On the tenth day TCD shows a “pattern of cerebral circulatory arrest” with absence of previously demonstrated flow with short enduring systolic spikes (125ms) with low systolic velocity (35cm/sec). 16 channels EEG, recorded according to the protocol for brain death did not show any electroencephalography activity. We confirmed brain death by all criteria and the patient entered heartbeating brain death donor program. Conclusion: Coregistration of transcranial Doppler-sonography and EEG is reliable diagnostic approach and criteria for detection of cerebral death.

Izvorni jezik
Engleski

Znanstvena područja
Kliničke medicinske znanosti

POVEZANOST RADA