CT angiography as a confirmatory test in brain death.
OBJECTIVE
From recent studies, it remains unclear whether CT angiography could be an alternative to other established ancillary tests for the diagnosis of brain death. We examined intracranial contrast enhancement in CT angiography after clinically established brain death and compared the results with EEG and TCD findings.


METHODS
Prospective study between April 2008 and January 2010. EEG, TCD and CT angiography were performed in 40 patients aged between 18 and 88 years (mean 56 years) who fulfilled the clinical criteria of brain death.


RESULTS
In all cases, the common carotid artery, cervical internal carotid artery, cervical vertebral artery and superficial temporal artery opacified in an arterial CT angiography series. 37 out of 40 cases demonstrated no opacification of both MCA-M4, ACA-A3, PCA-P2 segments, and BA.


CONCLUSIONS
CT angiography is a promising method of evaluating intracranial circulatory arrest in brain death with a high spatial and temporal resolution, superior to all other established technical procedures. The examination is easily accessible in most hospitals, operator independent, minimally invasive and inexpensive. Therefore, CT angiography has the potential to enlarge the existing armamentarium of confirmatory brain death tests.
Department of Neurosurgery, University Medicine Mainz, Johannes-Gutenberg-University, Mainz, Germany. welscheh@uni-mainz.de
Stefan
S
Welschehold
Stephan
S
Boor
Katharina
K
Reuland
Christian
C
Beyer
Thomas
T
Kerz
Andre
A
Reuland
Wibke
W
Müller-Forell
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001926:Brain Death / Q000175:diagnosis*; D002533:Cerebral Angiography / Q000379:methods*; D004569:Electroencephalography; D005260:Female; D006801:Humans; D021621:Imaging, Three-Dimensional; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed / Q000379:methods*; D017585:Ultrasonography, Doppler, Transcranial; D055815:Young Adult