Transcranial Doppler flow patterns in brain death: “Storm before the calm”

Rajagopal, Ramanan; Gupta, Ankush

doi:10.4103/neuroindia.ni_779_16

Cited by 2 publications

(1 citation statement)

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“…The diagnosis of cerebral circulatory arrest through TCD is supported by the appearance of at least one blood flow velocity pattern characteristic of cerebral circulatory arrest in all insonated intracranial vessels [12,13]. It is important to note that although these patterns are usually associated with increased pulsatility index, and increased resistance index, these values are not really relevant for diagnosis.…”

Section: Tcd: Sonography Patterns Of Cerebral Circulatory Arrest and Dncmentioning

confidence: 99%

Death by Neurological Criteria (DNC) in ICU: Usefulness of Transcranial Doppler (TCD)

Roldán

Alfaro

Gómez

2021

Neurosonology in Critical Care

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To determine brain death, a patient has to have suffered a medically and surgically irreversible structural brain injury. 2. Transcranial Doppler is very useful to support the diagnosis of cerebral circulatory arrest that accompanies the determination of Death by Neurological Criteria (DNC). 3. In order to establish the diagnosis of cerebral circulatory arrest by means of TCD/TCCS, we must contemplate the study of the anterior and posterior cerebral circulation. 4. There are three sonographic patterns compatible with the diagnosis of cerebral circulatory arrest: a) diastole-systole separation pattern, b) reverberant blood flow velocity pattern, and c) isolated systolic spike pattern. The absence of insonation in patients who had previously been insonated is considered by some to be compatible with the diagnosis of cerebral circulatory arrest. 5. Transcranial Doppler (TCD), like other auxiliary studies that estimate cerebral blood flow through blood flow velocities, has its main limitation in patients in whom there is no cranial hermetism (craniectomy, external ventricular drain, etc.). 6. Ancillary tests for the DNC (including Transcranial Doppler) have their main indication when the concept of global brain death is being used or it is not possible to complete the neurological examination and/or apnea test.

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Section: Tcd: Sonography Patterns Of Cerebral Circulatory Arrest and Dncmentioning

confidence: 99%