Dynamic computed tomography of cerebral circulatory arrest

Area of Science:

• Neurology
• Radiology
• Vascular Medicine

Background:

• Cerebral circulatory arrest is the physiological vascular correlate of brain death.
• Clinical diagnosis of brain death requires mandatory confirmation.
• Generalized abnormal cranial perfusion characterizes this condition.

Purpose of the Study:

• To confirm the efficacy of intravenous dynamic cranial computed tomography (CT) in evaluating cerebral circulatory arrest.
• To assess the utility of dynamic cranial CT in visualizing nonperfusion in brain death.

Main Methods:

• Retrospective analysis of eight consecutive patients with clinical diagnosis of cerebral death.
• Intravenous dynamic cranial computed tomography was performed.
• Assessment of blood flow and tissue perfusion in cerebral hemispheres, brainstem, and cerebellum.

Main Results:

• Observed stagnation of blood within major vessels at the base of the brain in all patients.
• Demonstrated complete gross nonperfusion of cerebral tissue, including hemispheres, brainstem, and cerebellum.
• Intravenous dynamic cranial CT identified generalized abnormal cranial perfusion characteristic of cerebral death.

Conclusions:

• Intravenous dynamic cranial computed tomography is an efficacious, noninvasive method for evaluating cerebral circulatory arrest.
• Dynamic cranial CT can aid in the immediate assessment of generalized abnormal cranial perfusion in brain death.
• This imaging technique complements clinical confirmation of brain death.