Tc-99m-hmpa0 single photon emission computed tomography (SPECT) as an ancillary test in the diagnosis of brain death

Keske, U.

doi:10.1007/s001340050687

Cited by 10 publications

(3 citation statements)

References 30 publications

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“…All radionuclide techniques demand special equipment and logistics and are therefore also not available in all hospitals. 19 TCD sonography is feasible at bedside, but the results are highly investigator dependent and can be hampered by nonexisting acoustic windows. 8,20 Evoked potentials only allow an examination of specific neuronal pathways but are not applicable in infratentorial lesions and are only approved in individual countries as additional confirmatory test.…”

Section: Discussionmentioning

confidence: 99%

Computed tomographic angiography as a useful adjunct in the diagnosis of brain death

Welschehold

Kerz²,

Boor³

et al. 2013

Journal of Trauma and Acute Care Surgery

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Section: Discussionmentioning

confidence: 99%

Computed tomographic angiography as a useful adjunct in the diagnosis of brain death

Welschehold

Kerz²,

Boor³

et al. 2013

Journal of Trauma and Acute Care Surgery

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“…Using MR venography we were able to demonstrate the visualization of veins and smaller vessels in the control group but not in BD patients. The partial superior sagittal sinus opacification seen in 3 BD patients has also been described in approximately 50% of BD patients studied with two-phase spiral CT [15] or Tc-99m-HMPAO scintigraphy [24] and could be interpreted as the result of circulation through meningeal vessels or via bridging veins [15,25]. Although the reason for the cessation of cerebral blood flow in BD patients is uncertain, it has been suggested to be the result of an intracranial pressure higher than the mean arterial pressure resulting from diffuse brain edema [12,23].…”

Section: Discussionmentioning

confidence: 99%

Contribution of MRI and MR angiography in early diagnosis of brain death

Paterakis

et al. 2002

Eur Radiol

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The objective of this study was to investigate whether the findings of MR imaging and MR angiography could accurately and early diagnose brain death in comatose patients. Thirty comatose patients were studied with MRI and MR arteriography. In 20 patients (group A) presenting with a Glasgow coma scale (GCS) 3-6, the final clinical diagnosis was brain death. In ten comatose patients with a GCS 4-6 and no clinical signs of brain death (group B), the clinical follow-up did not reveal brain death in a period of 12 months. The MRI examination consisted of turbo fluid-attenuated inversion recovery and T2 turbo spin-echo pulse sequences. The MR arteriography was performed with a 3D inflow pulse sequence. In 12 patients with brain death and 5 patients with no signs of brain death, a 3D phase contrast MR venography was also ap-plied. Magnetic resonance imaging in all patients showed variable edema with swelling of the cerebral gyri, small ventricular system, and basilar subarachnoid spaces. In group A, MRI in addition showed tonsillar herniation. In group A, MR arteriography revealed no arterial flow in the intracranial circulation, whereas MR venography showed in 9 patients no opacification of the sagittal and straight sinuses or visualization of intracranial veins. In contrast, MR angiography showed intact intracranial vessels in patients of group B. In conclusion, MR imaging and MR angiography may be reliable ancillary tests for use in early diagnosis of brain death and further work is required to validate its utility.

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“…B e yin ödemi patofizyolojik olarak, vazojenik veya sitotoksik mekanizmalarla oluşabilir (2). İntrakraniyal ba sınç serebral dolaşımı önleyecek düzeylere çıkarsa, beyinde aseptik nekroz oluşur ve 3-5 gün içerisinde beyin dokusu sıvımsı bir kitle görünümünü alır (3 Şüpheli durumlarda tanının netleştirilmesi açısın dan birtakım testler faydalı olabilirler.Bu testler de her zaman tam ve güvenilir sonuç vermeyebilir (6,7).…”

Section: Discussionunclassified

Beyin Ölümü Tanısı İçin Doğrulatıcı Bir Test Olarak Radyonüklid Perfüzyon Çalışması Olgu Sunumu

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K oroğlu N, İy ilikçi L, G ü n erli A. B ey in ölüm ü tan ısı için d oğ ru la tıcı bir test o la r a k r a d y o n ü k lid p er fü z y o n çalışm ası (olgu sunum u). A d li ÖZETBeyin ölümü, yaklaşık 40 yıl önce tanımlanmasına rağ men, tanımı, tanısı ve belgelendirilmesi farklılıklar içermek tedir. Kafa travması geçiren 7 yaşındaki olgu konsültanlar tarafından ilk değerlendirmesinde, beyin sapı refleksleri, pupillerin durumu, ışık refleksi, ağrılı uyarana yanıt, kalorik test, korneal refleks, öğürme refleksi, atropin testi, apne tes ti ve EEG'sine bakılarak beyin ölümü olarak kabul edildi. Altı saat sonra ağrılı uyarana motor yanıt gelişti. Konsültan pediyatrik nörolog, bu yanıtı spinal refleks olarak tanımla-yamadı. Bunun üzerine beyin ölümünü düşündüren Tc-99m HMPAO SPECT statik ve dinamik çalışmaları gerçekleştirildi. Fakat, tekrarlanan EEG'sinde sol frontotemporal bölgede minimal elektriksel aktivite gözlendi. Yatışının 16. gününde olgu eksitus oldu. Beyin ölümünün tanısında, bir takım ile ri tetkiklerin faydalı olabileceğini, fakat aynı zamanda değişik sonuçlar verebileceğini ve tekrarlayan değerlendir melerin beyin ölümünün tanısında önemli olacağını düşün mekteyiz.A n ah tar K elim eler: Şüpheli beyin ölümü, Radyonüklid perfüzyon çalışması. SUMMARYAlthough brain death was first described clinically near ly 40 years ago, its definition, diagnosis and certification may be various in different centers. In a 7 years old child who had head trauma, the consultants decided that he had brain death after their first evaluation of brain stem reflex es, pupils, light reflex, response to painfull stimulus, caloric test, corneal reflex, gag reflex, atropin test and EEG. Six hours later he developed a motor response to painfull sti muli. The consultant pediatric neurologist could not define this response as a spinal reflex. Therefore we performed Tc99m HMPAO SPECT static and dynamic studies which showed brain death. But, repeat EEG has shown minimal electrical activity in left fronto-temporal region. At sixteenth day of hopitalisation he died. We concluded that, some advanced studies may help us in the diagnosis o f brain death, but they can also show conflicting results and repeat ing evaluation is also important for the diagnosis o f brain death.

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Tc-99m-hmpa0 single photon emission computed tomography (SPECT) as an ancillary test in the diagnosis of brain death

Cited by 10 publications

References 30 publications

Computed tomographic angiography as a useful adjunct in the diagnosis of brain death

Computed tomographic angiography as a useful adjunct in the diagnosis of brain death

Contribution of MRI and MR angiography in early diagnosis of brain death

Beyin Ölümü Tanısı İçin Doğrulatıcı Bir Test Olarak Radyonüklid Perfüzyon Çalışması Olgu Sunumu

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