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Jesper Kelsen1, Karen Irgens Tanderup Hansen2,3, Andreas Hjelm Brandt1

  • 1Afdeling for Røntgen og Skanning, Københavns Universitetshospital - Rigshospitalet.

Ugeskrift for Laeger
|June 7, 2024
PubMed
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Danish brain death/death by neurological criteria (BD/DNC) require updates. Anoxic-ischaemic encephalopathy on CT scans after cardiac arrest may not need ancillary testing, with CT-angiography as a potential DSA alternative.

Area of Science:

  • Neurology
  • Medical Law

Background:

  • Danish brain death/death by neurological criteria (BD/DNC) legislation was enacted in 1990.
  • Approximately 100 patients annually meet BD/DNC criteria in Denmark.
  • Current criteria mandate specific ancillary investigations, including digital subtraction angiography (DSA).

Purpose of the Study:

  • To review and propose revisions to the current Danish BD/DNC criteria.
  • To evaluate the necessity of ancillary testing for specific findings.
  • To suggest alternative imaging modalities for ancillary investigations.

Main Methods:

  • Review of existing Danish BD/DNC legislation and guidelines.
  • Analysis of the role and necessity of ancillary investigations.
  • Evaluation of neuroimaging techniques for diagnosing BD/DNC.

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Main Results:

  • Visible anoxic-ischaemic encephalopathy on brain CT after cardiac arrest may not necessitate ancillary testing.
  • CT-angiography is proposed as a viable alternative to DSA for ancillary investigations.
  • The current BD/DNC criteria are deemed due for revision.

Conclusions:

  • The Danish BD/DNC criteria require modernization to reflect current medical understanding and technology.
  • Streamlining diagnostic protocols can improve efficiency without compromising accuracy.
  • Adoption of updated criteria and imaging techniques is recommended.