Brainstem death with persistent EEG activity: evaluation by xenon-enhanced computed tomography.
A patient with brainstem infarction met the clinical criteria for brain death but had persistent EEG activity, complicating our decision to withdraw life support. We evaluated cerebral blood flow with xenon-enhanced computed tomography (Xe/CT), which documented the absence of posterior circulation flow and persistent, low, anterior circulation flow. This information led us to withdraw life support, despite the presence of EEG activity. The Xe/CT method noninvasively measures local cerebral blood flow and may enhance diagnostic certainty in complicated brain-death evaluations.
D001926:Brain Death; D001933:Brain Stem / Q000503:physiopathology*; D002544:Cerebral Infarction / Q000503:physiopathology; D002560:Cerebrovascular Circulation; D004569:Electroencephalography; D006801:Humans; D008297:Male; D008875:Middle Aged; D014055:Tomography, Emission-Computed