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Related Experiment Videos

Brain death in infants: evaluation with Doppler US.

C M Glasier1, J J Seibert, W M Chadduck

  • 1Department of Radiology, University of Arkansas for Medical Sciences, Little Rock.

Radiology
|August 1, 1989
PubMed
Summary

Duplex pulsed Doppler ultrasonography (US) can aid in diagnosing infant brain death. Elevated resistive index (RI) with reversed diastolic flow indicates increased intracranial pressure and poor prognosis.

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Area of Science:

  • Pediatric Neurology
  • Diagnostic Imaging
  • Cerebrovascular Physiology

Background:

  • Diagnosing brain death in infants presents unique challenges.
  • Accurate and noninvasive diagnostic tools are crucial for timely intervention and management.
  • Assessing intracranial hemodynamics can provide valuable prognostic information.

Purpose of the Study:

  • To evaluate the utility of cranial duplex pulsed Doppler ultrasonography (US) in assessing intracranial blood flow in infants with clinically diagnosed brain death.
  • To determine if specific flow velocity parameters, such as resistive index (RI), correlate with brain death and increased intracranial pressure.

Main Methods:

  • A preliminary study involving nine infants with clinical brain death diagnoses.
  • Cranial duplex pulsed Doppler ultrasonography performed through the anterior fontanelle.

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  • Measurement of flow velocity in the internal carotid artery and anterior cerebral artery, calculating resistive index (RI).

    • Main Results:

    • Eight of nine infants exhibited markedly elevated RI (100%-191%) with reversal of diastolic flow.
    • One infant demonstrated preserved flow with a low RI (42%-58%) until death.
    • Elevated RI and diastolic flow reversal were interpreted as indicators of increased intracranial pressure.

    Conclusions:

    • Cranial duplex pulsed Doppler US is a valuable noninvasive tool for diagnosing brain death in infants.
    • Elevated RI with diastolic flow reversal is a significant indicator of increased intracranial pressure and poor prognosis.
    • Findings must be correlated with clinical examination and other diagnostic tests for definitive diagnosis.