Brain death: Radiologic signs of a non-radiologic diagnosis

Area of Science:

• Neurology
• Radiology
• Forensic Medicine

Background:

• Brain death is a clinical diagnosis of irreversible neurological function loss.
• Causes include trauma and subarachnoid hemorrhage, leading to cerebral edema and cessation of blood flow.
• Ancillary tests are crucial for confirming the clinical diagnosis.

Purpose of the Study:

• To review the clinical criteria, pathophysiology, pathology, and variations in brain death diagnosis.
• To discuss and review imaging findings used in diagnosing brain death.

Main Methods:

• Review of clinical criteria for brain death.
• Discussion of pathophysiology and pathology.
• Review of ancillary tests, including imaging (cerebral angiography, transcranial Doppler, cerebral scintigraphy, CT, MRI) and electroencephalography.

Main Results:

• Cerebral angiography, transcranial Doppler, and cerebral scintigraphy are validated imaging studies for brain death diagnosis.
• CT and MRI findings can suggest brain death but require validation.
• Electroencephalography demonstrates absent cortical electrical activity.

Conclusions:

• Brain death is a complex diagnosis requiring clinical assessment and confirmatory tests.
• Imaging plays a vital role in demonstrating the absence of cerebral blood flow.
• Understanding variations in practice and diagnostic criteria is essential for accurate diagnosis.