The case for brain death determination by CTA

Lamb, Taneya; Arumaithurai, Kogulavadanan; Shastri, Ravi; Putta, Swapna

doi:10.1097/ta.0b013e318247885a

Cited by 2 publications

(1 citation statement)

References 4 publications

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“…Computed tomographic angiography has been considered as a preferable method because it is easier, more available and is less expensive compared with scintigraphy; however, it is also a newer technique and it has additional risks associated with contrast medium. 8 There have been some reports about the role of ancillary testing in determining brain death. 9,10 These reports strongly suggest using brain blood flow analyses as a routine part of brain death investigation.…”

Section: Discussionmentioning

confidence: 99%

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Güzel

Zp²,

Ha³

et al. 2014

Exp Clin Transplant

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Objectives: Brain scintigraphy with Tc-99m-labeled diethylenetriaminopenta-acetic acid is a sensitive diagnostic method showing loss of cerebral blood flow that occurs after brain death. Cerebral blood flow can be quantitatively estimated by this method. The aim of this study was to compare histopathologic changes occurring with the decrease of cerebral blood flow (as shown by Tc-99m-labeled diethylenetriaminopenta-acetic acid brain death scintigraphy) after brain death in an experimental model. Materials and Methods:The study included examination of cerebral blood flow by Tc-99m-labeled diethylenetriaminopenta-acetic acid brain scintigraphy in the 20 rats, 1 day before brain death, after producing brain death in 11 surviving rats. Tc-99m-labeled diethylenetriaminopenta-acetic acid brain scintigraphy was performed under intubation and monitored. The Mann-Whitney U test was performed to compare groups (scintigraphic quantification results before and after brain death). Results: In the time activity curves generated from the analysis of the scintigraphies, decreases in counts in the brain death group were obtained in the arterial phase (P < .01). Decreases of the cerebral blood flow between the first and the sixth minutes were statistically significant (P < .05). Common principal histopathologic changes of the brain death (ie, autolysis and color loss in the nerve cells, diffuse edema, petechial hemorrhage in the brain tissues) were observed in all subjects. Conclusions: Quantitative findings of the brain scintigraphy by Tc-99m-labeled diethylenetriaminopenta-acetic acid was related with the histopathologic findings seen during the early brain death, with significant decreases of the cerebral blood flow. Quantification of Tc-99m-labeled diethylenetriaminopenta-acetic acid brain death scintigraphy as an easier and less-expensive scintigraphic method of cerebral blood flow might indicate a definite diagnosis of brain death and thus, potential donors can be determined earlier, leading to increased transplant rates.

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Section: Discussionmentioning

confidence: 99%

Untitled

Güzel

Zp²,

Ha³

et al. 2014

Exp Clin Transplant

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Computed Tomography Angiography in the Diagnosis Of Brain Death: A Systematic Review and Meta-Analysis

Kramer

Roberts

2014

Neurocrit Care

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Many patients who progress to brain death by accepted clinical or radiographic criteria have persistent opacification of proximal intracranial vessels when CTA is performed. The specificity of CTA in the diagnosis of brain death has not been adequately assessed. Routine use of CTA as an ancillary test in the diagnosis of brain death is therefore not recommended until diagnostic criteria have undergone further refinement and prospective validation. Absence of opacification of the internal cerebral veins appears to be the most promising angiographic criterion.

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The case for brain death determination by CTA

Cited by 2 publications

References 4 publications

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Computed Tomography Angiography in the Diagnosis Of Brain Death: A Systematic Review and Meta-Analysis

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