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Evaluation of brain death using transcranial Doppler.
D W Newell1, M S Grady, P Sirotta
1Department of Neurological Surgery, University of Washington School of Medicine, Seattle.
Neurosurgery
|April 1, 1989
Summary
Transcranial Doppler (TCD) identified a unique flow pattern in patients with brain death, indicating cessation of cerebral circulation. This non-invasive method aids in confirming brain death by assessing cerebral blood flow arrest.
Area of Science:
- Neurology
- Vascular Neurology
- Neurocritical Care
Background:
- Diagnosing brain death requires confirmation of circulatory arrest.
- Traditional methods can be invasive or time-consuming.
- Non-invasive techniques are sought for reliable assessment.
Purpose of the Study:
- To evaluate the utility of transcranial Doppler (TCD) in detecting cerebral blood flow arrest in brain death.
- To characterize the specific TCD findings associated with circulatory arrest.
Main Methods:
- Transcranial Doppler (TCD) was used to measure cerebral blood flow velocities.
- 12 patients meeting clinical criteria for brain death were studied.
- Results were correlated with radionuclide scanning for cerebral flow arrest.
Main Results:
- A characteristic reverberating flow pattern (systolic forward, diastolic retrograde) was observed.
- This TCD pattern consistently correlated with the arrest of cerebral circulation.
- Radionuclide scanning confirmed cessation of flow in all patients with the TCD pattern.
Conclusions:
- Transcranial Doppler (TCD) is a valuable, non-invasive tool for assessing cerebral circulation arrest.
- The identified TCD flow pattern is a reliable indicator of brain death.
- TCD facilitates the diagnosis of brain death by confirming circulatory arrest.