Radiological confirmation of brain death: digitised cerebral parenchymography. Preliminary report

Rates of organ procurement from brain dead subjects have fallen substantially in recent years. In France, the legal definition of brain death is based on electroencephalographic criteria in patients with clinical evidence of irreversible coma. However, sedative drugs used in intensive care units usually render the electroencephalogram uninterpretable, and in our medicolegal framework, it is necessary that intracerebral circulatory arrest be demonstrated. We discuss the value of the various available techniques and report our experience with digitised intra-arterial cerebral parenchymography. This simple, fast technique does not alter physiological conditions and provides high-quality images, ensuring prompt diagnosis, which is a prerequisite for optimal organ harvesting.