Detection of intracranial circulatory arrest in brain death using cranial CT‐angiography

Abstract

CT-A is easily accessible in almost every hospital, offers a high spatio-temporal resolution, is operator independent and inexpensive. The results of CT-A are comparable to other established brain perfusion techniques in BD. An international consensus should be established to ascertain consistent parameters similar to fixed guidelines for other ancillary procedures to determine BD in order to prevent different scanning and evaluation protocols for detecting intracranial circulatory arrest.

Brain Death

“…The results of CT-A are comparable to other established brain perfusion techniques in brain death [26].…”

CT angiography as a confirmatory test in diagnosis of brain death: comparison between three scoring systems

“…Recently, Welschehold et al (19,20) proposed that analysis of arterial vasculature should be carried out in the arterial scanning phase and that of deep venous system in the venous phase, as employed in our study. Besides those disparities, scanning time of arterial and venous phases also differ between studies.…”

“…In 2007, Combes et al (17) included the vessels of the posterior circulation (PCA-P2 and BA) into the scoring system in their study, creating the 10-point scale. Welchehold et al (19) also used this scoring system excluding GCV. Combes et al (17) proposed a sensitivity of 69.7%, while Welchehold et al (19) estimated a sensitivity of 95%.…”

Einsatz der CT-Angiographie zur Feststellung des zerebralen Zirkulationsstillstandes

“…Nachweis eines zerebralen Zirkulationsstillstandes durch fehlende Kontrastierung der intrakavernösen A. carotis interna beidseits (offener Pfeil) und der übrigen intraduralen Arterien bei guter Kontrastierung der A. temporalis superficialis beidseits und weiterer Externa-Äste (Pfeile). Die CTA wurde bisher ausschließlich für die Feststellung des zerebralen Zirkulationsstillstandes bei Erwachsenen validiert [3][4][5][6][7][8][9][10][11][12][13][14]. Bei klinischen Zeichen des irreversiblen Hirnfunktionsausfalles dürfte jedoch auch bei Kindern nach dem ersten Lebensjahr (geschlossene Fontanellen) der Nachweis des zerebralen Zirkulationsstillstandes mittels CTA ein relevanter prognostischer Indikator sein …”