Radionuclide Studies in the Determination of Brain Death: Criteria, Concepts, and Controversies

2008 ◽  
Vol 38 (4) ◽  
pp. 262-273 ◽  
Author(s):  
Lionel S. Zuckier ◽  
Johanna Kolano
2015 ◽  
Vol 2015 ◽  
pp. 1-5 ◽  
Author(s):  
Sindhaghatta Venkatram ◽  
Sara Bughio ◽  
Gilda Diaz-Fuentes

Practice guidelines from the American Academy of Neurology for the determination of brain death in adults define brain death as “the irreversible loss of function of the brain, including the brainstem.” Neurological determination of brain death is primarily based on clinical examination; if clinical criteria are met, a definitive confirmatory test is indicated. The apnea test remains the gold standard for confirmation. In patients with factors that confound the clinical determination or when apnea tests cannot safely be performed, an ancillary test is required to confirm brain death. Confirmatory ancillary tests for brain death include (a) tests of electrical activity (electroencephalography (EEG) and somatosensory evoked potentials) and (b) radiologic examinations of blood flow (contrast angiography, transcranial Doppler ultrasound (TCD), and radionuclide methods). Of these, however, radionuclide studies are used most commonly. Here we present data from two patients with a false positive Radionuclide Cerebral Perfusion Scan (RCPS).


PEDIATRICS ◽  
1995 ◽  
Vol 96 (3) ◽  
pp. 518-520
Author(s):  
Ken Okamoto ◽  
Tsuyoshi Sugimoto

It is generally assumed that the child's brain is more resistant to insults leading to death. Current guidelines for brain death, therefore, avoid application of these standards to young children.1 The determination of brain death in children, however, has become increasingly important, and different sets of new guidelines for children have been recently published.1-4 Especially, the recommendations of a special task force, consisting of representatives from neurologic organizations and the American Academy of Pediatrics, were published in five major journals.4 Those primary distinctions were three separate longer observation periods depending on the child's age and the necessity for two corroborating electroencephalograms (EEGs) or one EEG with a corroborating cerebral radionucleotide angiogram.


2018 ◽  
Author(s):  
Thomas I. Cochrane

Brain death is the state of irreversible loss of the clinical functions of the brain. A patient must meet strict criteria to be declared brain dead. They must have suffered a known and demonstrably irreversible brain injury and must not have a condition that could render neurologic testing unreliable. If the patient meets these criteria, a formal brain death examination can be performed. The three findings in brain death are coma or unresponsiveness, absence of brainstem reflexes, and apnea. Brain death is closely tied to organ donation, because brain-dead patients represent approximately 90% of deceased donors and thus a large majority of donated organs. This review details a definition and overview of brain death, determination of brain death, and controversy over brain death, as well as the types of organ donation (living donation versus deceased donation), donation after brain death, and donation after cardiac death. A figure presents a comparison of organ donation after brain death and after cardiac death, and a table lists the American Academy of Neurology Criteria for Determination of Brain Death. This review contains 1 highly rendered figure, 3 table, and 20 references.


PEDIATRICS ◽  
1984 ◽  
Vol 74 (4) ◽  
pp. 505-508
Author(s):  
Thomas W. Rowland ◽  
Joseph H. Donnelly ◽  
Anthony H. Jackson

Discontinuing ventilatory support for determination of respiratory drive is a recognized means of assessing clinical brain death. Methodology must include a means for assuring adequate oxygenation during the test as well as providing sufficient duration for appropriate hypercarbia. Nine patients with other findings of clinical brain death were prospectively assessed with a standardized apnea test protocol. None demonstrated spontaneous respirations. Whereas adequate oxygenation was maintained in each case, wide variability was evident in degree of hypercarbia and acidosis.


JAMA ◽  
2020 ◽  
Vol 324 (11) ◽  
pp. 1078 ◽  
Author(s):  
David M. Greer ◽  
Sam D. Shemie ◽  
Ariane Lewis ◽  
Sylvia Torrance ◽  
Panayiotis Varelas ◽  
...  

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