[Computed tomography as a tool to detect potential brain-dead donors].

Area of Science:

• Neurology
• Radiology
• Critical Care Medicine

Background:

• Brain death (BD) is a critical neurological outcome.
• Early detection of patients at risk for BD is crucial for patient management and organ donation considerations.
• Urgent head computed tomography (CT) scans are frequently performed in critically ill patients.

Purpose of the Study:

• To evaluate the efficacy of urgent head CT scan screening in identifying patients at high risk of progressing to brain death (BD).

Main Methods:

• Prospective observational study of 166 patients undergoing urgent head CT.
• Inclusion criteria: midline shift >5mm and/or decreased/absent basal cisterns.
• Follow-up for 28 days, recording epidemiological, clinical, and outcome data.

Main Results:

• 20.5% of patients progressed to BD.
• Intracerebral hemorrhage, low Glasgow Coma Scale score (<8), and altered basal cisterns were significant predictors of BD.
• Compression of basal cisterns increased BD risk 20-fold; absence increased risk 62.6-fold.

Conclusions:

• Easy-to-interpret CT findings, specifically basal cistern status, are powerful tools for screening patients at risk of BD.
• Urgent head CT can aid in early identification of patients likely to progress to brain death.