Brain perfusion SPECT for brain death assessment

Excerpt

A 54-year-old man was admitted to our emergency department in the context of an ischemic stroke. After clinical and imaging evaluation, a brain perfusion single-photon emission computed tomography (SPECT) exam was requested in order to assess brain death. Immediately after 555 MBq of ^99mTc-hexamethylpropyleneamine oxime (HMPAO) was administered (i.v.), a dynamic study of the head was performed, and 25 minutes after that, static anterior, posterior and lateral images were obtained. The left hemisphere shows no perfusion or cortical uptake. In contrast, the right hemisphere presents normal brain perfusion and preserved uptake of the radiopharmaceutical. This unusual result was useful for the exclusion of brain death and was compatible with the diagnosis of middle left cerebral artery occlusion. The patient died 2 days after the exam was performed. …