title: [Clinical usefulness of transcranial Doppler in diagnosis of brain death].
abstract: OBJECTIVE
  The use of transcranial doppler (TD) for the assessment of critical neurological patients and brain death (BD) is steadily growing. In this study we describe the daily clinical practice around BD diagnosis and compare the usefulness of TD, including advantages and shortcomings, with that of other tests.
  
  
  METHODS
  A series of 100 patients diagnosed of brain death is presented including the demographic and clinical data as well as the results of ancillary tests (CE).
  
  
  RESULTS
  Fifty eight patients were males with a mean age of 46. The most frequent etiology of coma was spontaneous cerebral hemorrhage. Central nervous system depressants had been administered to 62 patients within a few hours prior to the diagnosis. When ancillary tests were performed, only 55% patients fulfilled the currently accepted clinical criteria for brain death. TD was performed in 44 patients and 80% of them showed a pattern supporting a brain death diagnosis. Definitive diagnostic tests were electroencephalogram (EEG) in 53% patients and TD in 35% of them. In ten cases, discrepancies were observed between the results offered by these tests.
  
  
  CONCLUSIONS
  Transcraneal Doppler stands out as a safe, fast, inexpensive and bloodless method of assessment of the critical neurological patient and for BD diagnosis. It is the choice test in the presence of central nervous system depressant drugs, abuse of substances or coma of unknown etiology. The main limitations of this technique are the presence of extensive craniotomies and the absence of an adequate acoustic window.
authors.affiliation: Servicio de Neurología. Hospital Universitario La Fe. Valencia. Spain. evafa@ole.com
authors.forename: Eva
authors.initials: E
authors.lastname: Fages
authors.forename: José Ignacio
authors.initials: JI
authors.lastname: Tembl
authors.forename: Gerardo
authors.initials: G
authors.lastname: Fortea
authors.forename: Pablo
authors.initials: P
authors.lastname: López
authors.forename: Aida
authors.initials: A
authors.lastname: Lago
authors.forename: José Luis
authors.initials: JL
authors.lastname: Vicente
authors.forename: Juan Jesús
authors.initials: JJ
authors.lastname: Vilchez
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001926:Brain Death / Q000000981:diagnostic imaging*; D006801:Humans; D008297:Male; D008875:Middle Aged; D017585:Ultrasonography, Doppler, Transcranial