Clinical use of technetium-99m HM-PAO for determination of brain death.
We report our clinical experience with the use of [99mTc]hexamethyl propyleneamine oxime (HM-PAO) in establishing a diagnosis of brain death in 11 patients following trauma to the head and four patients who suffered atraumatic injuries. In 9/15 studies there was no intracranial flow present and brain death was then confirmed by standard criteria. Of the remaining 6/15 studies which showed evidence of cerebral perfusion, 3/6 patients underwent a subsequent HM-PAO study which showed cessation of perfusion. One additional patient died of pneumonia and two patients survived. Thus, in all cases where there was no flow present the diagnosis of brain death was later confirmed whereas three patients clinically thought to be brain dead showed significant perfusion and survived the cerebral trauma. HM-PAO may be useful in determination of brain death because it provides unequivocal results, can be performed by planar imaging at the bedside, and does not require withdrawal of medical therapy, thus allowing a diagnosis to be established more rapidly.
Reid
R H
RH
Division of Nuclear Medicine, Ottawa Civic Hospital Ontario, Canada.
Gulenchyn
K Y
KY
Ballinger
J R
JR
D001921:Brain / Q000098:blood supply / Q000000981:diagnostic imaging; D001926:Brain Death / Q000000981:diagnostic imaging*; D001930:Brain Injuries / Q000000981:diagnostic imaging*; D006801:Humans; D015609:Organotechnetium Compounds; D010091:Oximes; D011875:Radionuclide Angiography; D012039:Regional Blood Flow; D019690:Technetium Tc 99m Exametazime
D015609:Organotechnetium Compounds; D010091:Oximes; D019690:Technetium Tc 99m Exametazime