scholarly journals Bedside contrast-enhanced ultrasound diagnosing cessation of cerebral circulation in a neonate: A novel bedside diagnostic tool

2018 ◽  
Vol 31 (6) ◽  
pp. 578-580 ◽  
Author(s):  
Misun Hwang ◽  
Becky J Riggs ◽  
Sandra Saade-Lemus ◽  
Thierry AGM Huisman
Keyword(s):  
Blood Flow ◽  
Cardiac Arrest ◽  
Cerebral Blood Flow ◽  
Case Report ◽  
Brain Death ◽  
Unknown Etiology ◽  
Clinical Implications ◽  
Contrast Enhanced Ultrasound ◽  
Imaging Diagnosis ◽  
Contrast Enhanced

Imaging diagnosis of brain death is performed with either four-vessel cerebral angiography or radionuclide cerebral blood flow studies. Unfortunately, timely performance of either study at a critically ill period is not only cumbersome but not feasible in many cases. We present a case of a 6-month-old male three hours status post-cardiac arrest of unknown etiology who underwent contrast-enhanced ultrasound (CEUS) for diagnosis of near absent perfusion, or near brain death. The patient passed away 30 minutes after the exam and clinical diagnosis of brain death was confirmed. The case report highlights the utility of CEUS for diagnosis of brain death. This can have significant clinical implications in neonates who may not be eligible for commonly used, cumbersome radiologic studies for diagnosis of brain death.

Difficulties in assessing brain death in a case of benzodiazepine poisoning with persistent cerebral blood flow

2004 ◽  
Vol 23 (10) ◽  
pp. 503-505 ◽  
Author(s):  
Frédéric Marrache ◽  
Bruno Megarbane ◽  
Stéphane Pirnay ◽  
Abdel Rhaoui ◽  
Marie Thuong
Keyword(s):  
Blood Flow ◽  
Cardiac Arrest ◽  
Cerebral Blood Flow ◽  
Brain Death ◽  
Intracranial Hypertension ◽  
Multiorgan Failure ◽  
Deep Coma ◽  
Ventricular Drainage ◽  
Eeg Activity ◽  
Anoxic Injury

Assessing brain death may sometimes be difficult, with isoelectric EEG following psychotrope overdoses or normal cerebral blood flow (CBF) persisting despite brain death in the case of ventricular drainage or craniotomy. A 42-year-old man, resuscitated after cardiac arrest following a suicidal ingestion of ethanol, bromazepam and zopiclone, was admitted in deep coma. On day 4, his brainstem reflexes and EEG activity disappeared. On day 5, his serum bromazepam concentration was 817 ng/ml (therapeutic: 80-150). The patient was unresponsive to 1 mg of flumazenil. MRI showed diffuse cerebral swelling. CBF assessed by angiography and Doppler remained normal and EEG isoelectric until he died on day 8 with multiorgan failure. There was a discrepancy between the clinically and EEG-assessed brain death, and CBF persistence. We hypothesized that brain death, resulting from diffuse anoxic injury, may lead, in the absence of major intracranial hypertension, to angiographic misdiagnoses. Therefore, EEG remains useful to assess diagnosis in such unusual cases.

scholarly journals Detection and monitoring of postinterventional success and complications of the liver using contrast-enhanced ultrasound (CEUS) – a case report after interventional treatment of a giant hemangioma

2018 ◽  
Vol 20 (4) ◽  
pp. 536 ◽  
Author(s):  
Giovanna Negrao de Figueiredo ◽  
Johannes Rübenthaler ◽  
Katharina Müller-Peltzer ◽  
Dirk‑André Clevert
Keyword(s):  
Case Report ◽  
Transcatheter Arterial Embolization ◽  
Arterial Embolization ◽  
Interventional Treatment ◽  
Contrast Enhanced Ultrasound ◽  
Imaging Diagnosis ◽  
Important Complication ◽  
Fast Recognition ◽  
Contrast Enhanced ◽  
Assessment And Treatment

This case report relates the use of contrast-enhanced ultrasound (CEUS) for the assessment and treatment of a postinterventional cholecystitis, a rare but important complication after transcatheter arterial embolization of a giant hemangioma. Regarding the imaging diagnosis, hemangiomas have specific features allowing a fast recognition by all radiological modalities,and in recent years, especially by CEUS.

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