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KEY FACTS
Terminology
Imaging
TERMINOLOGY
Definitions
- Brain death (BD) is complete, irreversible cessation of brain function
- Legal definition of brain death
- Irreversible cessation of circulatory and respiratory functions
- Irreversible cessation of all functions of entire brain, including brainstem
- Most facilities require 2 independent clinical confirmations of brain death
- Primarily clinical diagnosis
- Ancillary studies used when clinical picture equivocal &/or to shorten length of observation period
- Brain death diagnosis important for organ donation status
- Imaging may confirm brain death but does not substitute for clinical criteria
IMAGING
General Features
Nuclear Medicine Findings
CT Findings
Angiographic Findings
MR Findings
Ultrasonographic Findings
Other Modality Findings
Imaging Recommendations
Artifacts and Quality Control
DIFFERENTIAL DIAGNOSIS
PATHOLOGY
General Features
Gross Pathologic & Surgical Features
CLINICAL ISSUES
Presentation
Demographics
Natural History & Prognosis
DIAGNOSTIC CHECKLIST
Consider
Selected References
- Seshadri A et al: Brain Death Evaluation and Determination. In: Salim A et al (eds): Surgical Critical Care Therapy. Springer, 2018
- PulmCrit: Brain death, mimics, and flow scans. https://emcrit.org/pulmcrit/brain-death-flow-scan. Published August 2017. Accessed December 2019
- Zuckier LS: Radionuclide evaluation of brain death in the post-McMath era. J Nucl Med. 57(10):1560-8, 2016
- Donohoe KJ et al: SNM practice guideline for brain death scintigraphy 2.0. J Nucl Med Technol. 40(3):198-203, 2012
- Wijdicks EF et al: Evidence-based guideline update: determining brain death in adults: report of the Quality Standards Subcommittee of the American Academy of Neurology. Neurology. 74(23):1911-8, 2010
- Booth CM et al: Is this patient dead, vegetative, or severely neurologically impaired? Assessing outcome for comatose survivors of cardiac arrest. JAMA. 291(7):870-9, 2004
- Belber CJ: Brain death documentation: analysis and issues. Neurosurgery. 53(4):1009; author reply 1009, 2003
- Conrad GR et al: Scintigraphy as a confirmatory test of brain death. Semin Nucl Med. 33(4):312-23, 2003
- Donohoe KJ et al: Procedure guideline for brain death scintigraphy. J Nucl Med. 44(5):846-51, 2003
- Harding JW et al: Outcomes of patients referred for confirmation of brain death by 99mTc-exametazime scintigraphy. Intensive Care Med. 29(4):539-43, 2003
- Flowers WM Jr et al: Accuracy of clinical evaluation in the determination of brain death. South Med J. 93(2):203-6, 2000
- Haupt WF et al: European brain death codes: a comparison of national guidelines. J Neurol. 246(6):432-7, 1999
- Pisani F et al: Sodium valproate and valpromide: differential interactions with carbamazepine in epileptic patients. Epilepsia. 27(5):548-52, 1986
- Young GB: Diagnosis of brain death. UpToDate Web site. http://www.uptodate.com/contents/diagnosis-of-brain-death. Updated May 17, 2012. Accessed February 10, 2015
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References
Tables
Tables
KEY FACTS
Terminology
Imaging
TERMINOLOGY
Definitions
- Brain death (BD) is complete, irreversible cessation of brain function
- Legal definition of brain death
- Irreversible cessation of circulatory and respiratory functions
- Irreversible cessation of all functions of entire brain, including brainstem
- Most facilities require 2 independent clinical confirmations of brain death
- Primarily clinical diagnosis
- Ancillary studies used when clinical picture equivocal &/or to shorten length of observation period
- Brain death diagnosis important for organ donation status
- Imaging may confirm brain death but does not substitute for clinical criteria
IMAGING
General Features
Nuclear Medicine Findings
CT Findings
Angiographic Findings
MR Findings
Ultrasonographic Findings
Other Modality Findings
Imaging Recommendations
Artifacts and Quality Control
DIFFERENTIAL DIAGNOSIS
PATHOLOGY
General Features
Gross Pathologic & Surgical Features
CLINICAL ISSUES
Presentation
Demographics
Natural History & Prognosis
DIAGNOSTIC CHECKLIST
Consider
Selected References
- Seshadri A et al: Brain Death Evaluation and Determination. In: Salim A et al (eds): Surgical Critical Care Therapy. Springer, 2018
- PulmCrit: Brain death, mimics, and flow scans. https://emcrit.org/pulmcrit/brain-death-flow-scan. Published August 2017. Accessed December 2019
- Zuckier LS: Radionuclide evaluation of brain death in the post-McMath era. J Nucl Med. 57(10):1560-8, 2016
- Donohoe KJ et al: SNM practice guideline for brain death scintigraphy 2.0. J Nucl Med Technol. 40(3):198-203, 2012
- Wijdicks EF et al: Evidence-based guideline update: determining brain death in adults: report of the Quality Standards Subcommittee of the American Academy of Neurology. Neurology. 74(23):1911-8, 2010
- Booth CM et al: Is this patient dead, vegetative, or severely neurologically impaired? Assessing outcome for comatose survivors of cardiac arrest. JAMA. 291(7):870-9, 2004
- Belber CJ: Brain death documentation: analysis and issues. Neurosurgery. 53(4):1009; author reply 1009, 2003
- Conrad GR et al: Scintigraphy as a confirmatory test of brain death. Semin Nucl Med. 33(4):312-23, 2003
- Donohoe KJ et al: Procedure guideline for brain death scintigraphy. J Nucl Med. 44(5):846-51, 2003
- Harding JW et al: Outcomes of patients referred for confirmation of brain death by 99mTc-exametazime scintigraphy. Intensive Care Med. 29(4):539-43, 2003
- Flowers WM Jr et al: Accuracy of clinical evaluation in the determination of brain death. South Med J. 93(2):203-6, 2000
- Haupt WF et al: European brain death codes: a comparison of national guidelines. J Neurol. 246(6):432-7, 1999
- Pisani F et al: Sodium valproate and valpromide: differential interactions with carbamazepine in epileptic patients. Epilepsia. 27(5):548-52, 1986
- Young GB: Diagnosis of brain death. UpToDate Web site. http://www.uptodate.com/contents/diagnosis-of-brain-death. Updated May 17, 2012. Accessed February 10, 2015
