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Klinische Neurophysiologie 2014; 45(03): 168-175
DOI: 10.1055/s-0034-1387208
Originalia
© Georg Thieme Verlag KG Stuttgart · New York

Sonografische Methoden in der Hirntoddiagnostik

Ultrasound Methods in the Diagnosis of Brain Death
A. Günther
1   Hans-Berger-Klinik für Neurologie, Universitätsklinikum Jena
4   Integriertes Forschungs- und Behandlungszentrum (IFB) Sepsis und Sepsisfolgen (CSCC; Center for Sepsis Control & Care)
,
J. A. Llompart-Pou
2   Intensive Care Unit, Hospital Universitari Son Espases, Palma de Mallorca, Illes Balears, Spanien
,
C. Klingner
1   Hans-Berger-Klinik für Neurologie, Universitätsklinikum Jena
,
O. W. Witte
1   Hans-Berger-Klinik für Neurologie, Universitätsklinikum Jena
4   Integriertes Forschungs- und Behandlungszentrum (IFB) Sepsis und Sepsisfolgen (CSCC; Center for Sepsis Control & Care)
,
C. Terborg
3   Klinik für Neurologie, Asklepios-Klinik St. Georg, Hamburg
› Institutsangaben
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Publikationsverlauf

Publikationsdatum:
09. September 2014 (online)

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Zusammenfassung

Die Hirntoddiagnostik ist eines der wichtigsten diagnostischen Verfahren in der Intensivmedizin. Nach Prüfung der Voraussetzungen und klinischer Feststellung von Koma und Hirnstammareflexie sind sonografische Methoden zum Nachweis der Irreversibilität von großer Bedeutung. Bei entsprechender Expertise ist die sonografische Diagnose des zerebralen Zirkulationsstillstandes mit hoher Sensitivität und Spezifität möglich, wenn intrakraniell in den Gefäßen des Circulus Willisii ein Pendelfluss oder systolische Spitzen in einem Abstand von 30 Minuten detektiert werden. Allerdings sollten limitierende Faktoren beachtet werden, die die Anwendung sonografischer Methoden in der Hirntoddiagnostik einschränken können.

Abstract

Brain death detection is one of the most important diagnostic procedures in intensive care medicine. If prerequisites and the clinical brain death syndrome are given, confirmatory tests e.g. sonographic methods are of high importance. Sonographic detection of cerebral circulatory arrest is possible with high sensitivity and specificity in skilled physicians, if oscillatory flow or systolic spikes are detected in the arteries of the Circle of Willis within a minimum 30 minute interval. However, limitations for the use of ultrasound methods in brain death detection must be considered.

Schlüsselwörter

Hirntod - konfirmatorische Untersuchung - Zirkulationsstillstand - Ultraschall - Pendelfluss - systolische Spitzen

Keywords

brain death - confirmatory test - circulatory arrest - ultrasound - oscillatory flow - systolic spikes
 

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