Subscribe to RSS
DOI: 10.1055/s-0030-1267209
© Georg Thieme Verlag KG Stuttgart · New York
Usefulness of Addition of CT Perfusion to CT Angiography for Brain Death Diagnosis in a Child
Publication History
received 02.12.2008
accepted 17.09.2010
Publication Date:
17 November 2010 (online)
![](https://www.thieme-connect.de/media/neuropediatrics/201004/lookinside/thumbnails/10.1055-s-0030-1267209-1.jpg)
Abstract
CT perfusion is a new technique that is rapid, available and minimally invasive which provides functional vascular information and can be made after conventional CT and CT angiography at the same imaging session. CT perfusion applications have focused on ischemic stroke with only a short series of applications to brain death diagnosis. Instead, CT angiography is frequently performed as a confirmatory test of brain death, but it has not been completely validated yet. Hence CT perfusion may help in supporting the diagnosis of brain death. We present the case of a 12-year-old child with clinical criteria for brain death who required a confirmatory test. CT angiography and CT perfusion were performed. Both revealed the absence of any intracranial blood flow which supported the clinical diagnosis of brain death.
Key words
CT perfusion - CT angiography - brain death - child
References
- 1 Banasiak KJ, Lister G. Brain death in children. Curr Opin Pediatr. 2003; 15 288-293
- 2 Combes JC, Chomel A, Ricolfi F. et al . Reliability of computed tomographic angiography in the diagnosis of brain death. Transplant Proc. 2007; 39 16-20
- 3 Dupas B, Gayet-Delacroix M, Villers D. et al . Diagnosis of brain death using two-phase spiral CT. AJNR Am J Neuroradiol. 1998; 19 641-647
- 4 Escudero D, Otero J, Vega P. et al . Diagnosis of brain death by multislice CT scan: angioCT scan and brain perfusion. Med Intensiva. 2007; 31 335-341
- 5 Escudero D, Otero J, Marqués L. et al . Diagnosing brain death by CT perfusion and multislice CT angiography. Neurocrit Care. 2009; 11 261-271
- 6 Frampas E, Videcoq M, de Kerviler E. et al . CT angiography for brain death diagnosis. AJNR Am J Neuroradiol. 2009; 30 1566-1570
- 7 Harrigan MR, Leonardo J, Gibbons KJ. et al . CT perfusion cerebral blood flow imaging in neurological critical care. Neurocrit Care. 2005; 2 352-366
- 8 Hoeffner EG, Case I, Jain R. et al . Cerebral perfusion CT: technique and clinical applications. Radiology. 2004; 231 632-644
- 9 Leclerc X, Taschner CA, Vidal A. et al . The role of spiral CT for the assessment of the intracranial circulation in suspected brain-death. J Neuroradiol. 2006; 33 90-95
- 10 Lima FO, Lev MH, Levy RA. et al . Functional contrast-enhanced ct for evaluation of acute ischemic stroke does not increase the risk of contrast-induced nephropathy. AJNR Am J Neuroradiol.. 2009 Dec 31; [Epub ahead of print]
- 11 Quesnel C, Fulgencio JP, Adrie C. et al . Limitations of computed tomographic angiography in the diagnosis of brain death. Intensive Care Med. 2007; 33 2129-2135
- 12 Qureshi AI, Kirmani JF, Xavier AR. et al . Computed tomographic angiography for diagnosis of brain death. Neurology. 2004; 24;62 652-653
- 13 Wijdicks EF. The diagnosis of brain death. N Engl J Med. 2001; 19 1215-1221
- 14 Wintermark M, Cotting J, Roulet E. et al . Acute brain perfusion disorders in children assessed by quantitative perfusion computed tomography in the emergency setting. Pediatr Emerg Care. 2005; 21 149-160
- 15 Yu SL, Lo YK, Lin SL. et al . Computed tomographic angiography for determination of brain death. Comput Assist Tomogr. 2005; 29 528-531
Correspondence
Raúl Pellón
Department of Radiology
Hospital Universitario Marqués
de Valdecilla
AV Valdecilla sn
39008 Santander
Spain
Email: hoznayin@hotmail.com