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Determination of brain death


Authors: Drahoslava Nováková;  Otakar Kraft;  Radoslava Drozdková
Authors‘ workplace: Klinika nukleární medicíny, FN Ostrava
Published in: NuklMed 2012;1:53-57
Category: Review Article

Overview

Introduction:
Brain perfusion scintigraphy serves as a reliable tool to determine brain death for transplantation medicine or for termination of resuscitation. Brain death means irreversible termination of all brain functions including functions of brain stem irrespective to persisting functions of cardiovascular system and other organs. Determination of brain death is an essential diagnosis for donation of organs for transplantation. Permission of removing organs from donors and rules for death determination is securely protected by the Czech legislation.

Method:
Examinations are performed with dual-head gamma cameras from Siemens in our department from year 2003. Radiopharmaceutical Tc-99m HMPAO is injected intravenously as a bolus. Dynamic phase is acquired in an anterior view, static phase in anterior, posterior and both lateral views.

Results:
We performed 124 examinations in 118 patients (103 adults and 15 children) with clinical symptoms of brain death – potential donors of organs from 2003 to June 2012. We do not confirm brain death in 8 patients. Organ removing was not performed in 23 patients due to different contraindications or due to lack of permission from parents or representatives in children.

Conclusion:
Brain perfusion scintigraphy is a non-invasive, simple and convenient method which is almost without false positive findings. There are no risks of complications. Therefore, its inclusion into the process of brain death determination is fully justified.

Key words:
brain death, brain scintigraphy, brain angiography, transplantation


Sources

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