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)