Braindeath.org - A site dedicated to provide information about brain death
 

This information is based on the American Acadamy of Neurology Guidelines.

Common confirmatory tests in Brain Death

Cerebral angiography·

  • Contrast medium under high pressure in both anterior and posterior circulation injections·
  • No intracerebral filling at the level of the carotid or vertebral artery entry to the skull·
  • Patent external carotid circulation·
  • Possible delayed filling of the superior longitudinal sinus

Electroencephalography·

  • Minimum of eight scalp electrodes·
  • Interelectrode dependencies should be between 100 and 10,000·
  • Integrity of the entire recording system should be tested·
  • Electrode distances should be at least 10 cm·
  • Sensitivity should be increased to at least 2 µV for 30 minutes with inclusion of appropriate calibrations·
  • High-frequency filter setting should be at 30 Hz, and low-frequency setting should not be below 1 Hz·
  • There should be no electroencephalographic reactivity to intense somatosensory or audiovisual stimuli

Transcranial Doppler ultrasonography·

  • Bilateral insonation.
  • The probe is placed at the temporal bone above the zygomatic arch or the vertebrobasilar arteries through the suboccipital transcranial window·
  • The abnormalities should include a lack of diastolic or reverberating flow, small systolic peaks in early systole, and a lack of flow found by the investigator who previously demonstrated normal velocities

Cerebral scintigraphy (technetium Tc 99m hexametazime)·

  • Injection of isotope within 30 minutes of reconstitution·
  • Static image of 500,000 counts at several time intervals: immediately, between 30 and 60 minutes, and at 2 hours·
  • Correct intravenous injection needs to be confirmed with additional liver images demonstrating uptake (optional)

 

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