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Confirming the brain death diagnosis using brain CT angiography: experience in Tokat State Hospital
Kayhan Karakuş1, Seden Demirci2, Aysun Yakut Cengiz1
1Department of Radiology, Sivas Numune Hospital Sivas, Turkey.
Objective:
Fourteen brain death cases diagnosed in Mart 2012-May 2013 period in Tokat State Hospital were studied retrospectively. CT angiography experience about those cases was shared, and use of CT angiography in confirmation of brain death was discussed.
Material And Methods:
All 14 cases were patients on mechanical ventilator, who did not respond to medical and surgical treatments at intensive care unit and were diagnosed clinically with brain death. All of these patients had CT angiography as a confirmatory test using a 4-slice CT scanner in Radiology department in Tokat State Hospital.
Findings:
Six of the patients were female and eight were male. All of them were referred from intensive care unit and had clinical brain death diagnosis before CT angiography. In the evaluation of CTA, four-point scoring involving opacification loss in both ICVs and cortical segments of MCA was used. CTA examinations confirmed brain death diagnoses in all patients who had clinical brain death diagnoses, and no confliction between CTA findings and clinical diagnoses was observed.
Conclusion:
Demonstrating the lack of cerebral circulation is a necessity for confirmation of brain death diagnosis. While conventional angiography remains the standard method, CTA emerged as an alternative method. In parallel to increase in prevalence of organ implants, CTA, a fast and efficient method, has been increasingly used in confirmation of brain death diagnoses.
Insights
CT angiography confirmed brain death diagnoses in all 14 cases, showing no conflict with clinical findings. This fast and efficient method is a valuable alternative for confirming brain death, especially with rising organ donation rates.
Area of Science:
- Neurology
- Radiology
- Critical Care Medicine
Background:
- Brain death diagnosis requires confirmation of absent cerebral circulation.
- Conventional angiography is the standard, but alternative methods are needed.
- Increasing organ transplantation necessitates efficient diagnostic tools.
Purpose of the Study:
- To evaluate the utility of CT angiography (CTA) in confirming clinical brain death diagnoses.
- To share experience with CTA in a series of brain death cases.
- To discuss the role of CTA as an alternative diagnostic method.
Main Methods:
- Retrospective study of 14 brain death cases diagnosed between March 2012 and May 2013.
- All patients were mechanically ventilated and clinically diagnosed with brain death.
- CTA was performed using a 4-slice CT scanner as a confirmatory test.
Main Results:
- 14 patients (6 female, 8 male) with clinical brain death underwent CTA.
- A four-point scoring system evaluated opacification loss in ICVs and MCAs.
- CTA confirmed brain death in all cases, with no discrepancies between CTA and clinical diagnoses.
Conclusions:
- CTA is a reliable alternative to conventional angiography for confirming brain death.
- The method is fast and efficient, supporting its use in organ donation contexts.
- CTA findings correlated perfectly with clinical brain death diagnoses in this cohort.