Time dependent validity in the diagnosis of brain death using transcranial Doppler sonography.

Journal of Neurology, Neurosurgery, and Psychiatry
J-R KuoK-C Lin

Abstract

To evaluate the validity of transcranial Doppler (TCD) in confirming brain death from various pathological conditions. An observational case-control study over a 2.5 year period, in which transcranial Doppler (TCD) examinations were done on 101 comatose patients for confirmation of brain death. Between October 2002 to May 2005, 44 clinically diagnosed brain death cases (29 male, 15 female; mean (SD) age, 46.5 (19.5) years; Glasgow Coma Scale (GCS) score, 3.0 (0.0)) and 57 controls (36 male, 21 female; age 48.1 (16.5) years; mean GCS, 4.9 (1.7)) were examined. Reverse diastolic flow, very small systolic spikes, or no signals were considered characteristic of cerebral circulatory arrest. The sensitivity and specificity of TCD examination of both the basilar artery and the middle cerebral arteries (MCAs) in confirming brain death were 77.2% and 100%, respectively. The sensitivity of TCD-diagnosed brain death increased with elapsed time. There was a trend for the basilar artery to have greater sensitivity (86.4% v 77.2%), higher positive predictive value (90.5% v 85.1%), and fewer false negatives (14% v 23.7%) than the MCAs for diagnosing brain death (all NS). The consistency of the basilar artery and the MCAs for diagnosing brain ...Continue Reading

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May 16, 2009·Neurocritical Care·Katharina M Busl, David M Greer
Apr 21, 2007·Critical Care Medicine·Maher SaqqurAndrew Demchuk
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Dec 25, 2019·Critical Care : the Official Journal of the Critical Care Forum·Chiara Robba, Fabio Silvio Taccone
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Oct 17, 2017·Critical Ultrasound Journal·Vincent Issac Lau, Robert Thomas Arntfield

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