Angiographic Findings in Brain Death*

Kricheff, Irvin I.; Pinto, Richard S.; George, Ajax E.; Braunstein, Philip; Korein, Julius

doi:10.1111/j.1749-6632.1978.tb50338.x

Cited by 61 publications

(30 citation statements)

References 20 publications

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“…In Germany, the intervals oŸ repeat clinical evaluation are at least 12 hours in patients with p¡ and at least 72 hours in those with secondary brain [6,29,30]. Die Bedeutung der intraarte¡ AnNographie, die schon seit den 70er Jahren als aussagekr~iftigste Methode zur Feststellung des zerebralen Zirkulationsstillstands gilt [3,6,15,29], wird international immer ge¡ da diese invasive Untersuchung eine potentielle Gefahr ftir den Patienten darstellt. Die Feststellung des zerebralen Zirkulationsstillstands ist in Deutschland keine Indikation zur Durchfª einer Angiographie [30].…”

Section: Abstilact Determining Brain Death In Germanyunclassified

Aktueller Stand der Hirntoddiagnostik in Deutschland

Thömke

Weilemann

2000

Med Klin

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Diagnosis of brain death requires definite evidence of an acute CNS catastrophe and exclusion of complicating medical conditions that may confound clinical assessment. Acute CNS catastrophe may be due to direct ("primary") brain damage (e.g., intracerebral hemorrhage, severe concussion, brain tumors), or indirect ("secondary") brain damage (e.g., cerebral hypoxia following cardio-pulmonary resuscitation). The cardinal findings in brain death are coma, absence of brainstem reflexes, and apnea. Persistence of these clinical signs determines brain death. In Germany, the intervals of a repeat clinical evaluation are at least 12 hours in patients with primary, and at least 72 hours in those with secondary brain damage. Electroencephalographically documented absence of electrical activity for at least 30 minutes or by means of transcranial Doppler ultrasonography or isotope angiography documented intracranial circulatory arrest also confirm brain death. Under such conditions, a repeat clinical evaluation is unnecessary in patients with clinical brain death signs. First of all, brain death is a clinical diagnosis. Confirmatory tests are not mandatory in most situations. In Germany, confirmatory tests are required in newborns, infants below the age of 2 years, and patients with infratentorial brain damage.

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Section: Abstilact Determining Brain Death In Germanyunclassified

Aktueller Stand der Hirntoddiagnostik in Deutschland

Thömke

Weilemann

2000

Med Klin

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“…Previous digital angiography studies have demonstrated persistent residual flow in the carotid siphon of BD patients [38][39][40] . However, other authors have observed that patients with an isolated residual flow in the internal carotid artery siphon suffered from BD, which was confirmed by other tests (e.g., EEG) 41,42 .…”

Section: Criteria Of the Brazilian Academy Of Neurology For The Diagnmentioning

confidence: 99%

Brazilian guidelines for the application of transcranial ultrasound as a diagnostic test for the confirmation of brain death

Lange

Zétola

Alves

et al. 2012

Arq. Neuro-Psiquiatr.

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Neurosonological studies, specifically transcranial Doppler (TCD) and transcranial color-coded duplex (TCCD), have high level of specificity and sensitivity and they are used as complementary tests for the diagnosis of brain death (BD). A group of experts, from the Neurosonology Department of the Brazilian Academy of Neurology, created a task force to determine the criteria for the following aspects of diagnosing BD in Brazil: the reliability of TCD methodology; the reliability of TCCD methodology; neurosonology training and skills; the diagnosis of encephalic circulatory arrest; and exam documentation for BD. The results of this meeting are presented in the current paper.Key words: transcranial Doppler, encephalic circulatory arrest, brain death. resumo Estudos neurossonológicos, especialmente o Doppler transcraniano (DTC) e o duplex transcraniano codificado a cores (DTCC), apresentam elevados níveis de especificidade e sensibilidade quando utilizados como exames complementares no diagnóstico de morte encefálica (ME). Um grupo de peritos do Departamento Científico de Doppler transcraniano da Academia Brasileira de Neurologia criou uma força-tarefa de forma a determinar os critérios neurossonológicos para os seguintes aspectos no diagnóstico de ME no Brasil: metodologia do DTC; metodologia do DTCC; treinamento e habilidades em Neurossonologia; diagnóstico de parada circulatória encefálica e documentação do exame para a ME. Os resultados deste encontro foram apresentados neste artigo.Palavras-Chave: Doppler transcraniano, parada circulatória encefálica, morte encefálica.

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“…Earlier cerebral angiography findings demonstrated a cessation of cerebral blood flow when the ICP approached MAP 7,[15][16][17] . Therefore, there was no observed cross-filling of the ACom at markedly elevated ICPs.…”

Section: Positive Correlation Between Icp and Crossfilling Of Acommentioning

confidence: 99%

“…All CT scans were per- prior to initial angiography and prior to follow-up angiography without knowledge of the original reports. The neuroradiologist graded the degree of subarachnoid hemorrhage according to the Fisher scale, and the degree of hydrocephalus as none, minimal, mild, moderate or severe [15][16][17] . Degree of hydrocephalus was then converted to a numerical value as follows: 0-none, 1-minimal, 2-mild, 3-moderate, 4-severe.…”

Section: Ctmentioning

confidence: 99%