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01-02-2019 | Diagnostic Neuroradiology

The role of cervical color Doppler ultrasound in the diagnosis of brain death

Authors: Alessandro Pedicelli, Margherita Bartocci, Emilio Lozupone, Francesco D’Argento, Andrea Alexandre, Giuseppe Garignano, Ciro D’Alò, Viola Giacobbe, Iacopo Valente, Cesare Colosimo

Published in: Neuroradiology | Issue 2/2019

Abstract

Purpose

Brain death (BD) is defined as the irreversible destruction of all brain functions. It is usually diagnosed through a clinical examination, but in certain circumstances, ancillary examinations (such as digital subtraction angiography (DSA), transcranial color Doppler (TCD), computed tomography angiography (CTA), magnetic resonance angiography (MRA), or radionuclide scanning) are required as confirmatory tests. In many countries, cervical color Doppler sonography (CCD) is not recognized as a valid test.

The aim of our study is to assess its accuracy as a non-invasive, inexpensive, and easily available examination to determine cerebral circulatory arrest (CCA).

Methods

We performed a retrospective study in which 123 patients with clinical diagnosis of BD underwent bedside cervical color Doppler as an additional examination for CCA assessment. We compared these cervical color Doppler findings with the results of validated ancillary tests such as CTA, TCD, and DSA.

Results

Cervical color Doppler exams showed a sensitivity of 78% (96/123 patients) in detecting CCA compared to standard ancillary tests. Twenty-seven patients showed a persistent diastolic flow in one or two of the four arterial vessels examined and thus considered as false negatives.

Conclusion

Our results show that cervical color Doppler may become a reliable and safe technique in detecting CCA, which can shorten the time for declaring brain death. In particular, in patients lacking good bone windows at transcranial color Doppler, cervical color Doppler of the cervical internal carotids and vertebral arteries could be recommended to increase the sensitivity of transcranial color Doppler, or as an alternative bedside examination.

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Title: The role of cervical color Doppler ultrasound in the diagnosis of brain death
Authors: Alessandro Pedicelli
Margherita Bartocci
Emilio Lozupone
Francesco D’Argento
Andrea Alexandre
Giuseppe Garignano
Ciro D’Alò
Viola Giacobbe
Iacopo Valente
Cesare Colosimo
Publication date: 01-02-2019
Publisher: Springer Berlin Heidelberg
Published in: Neuroradiology / Issue 2/2019
Print ISSN: 0028-3940
Electronic ISSN: 1432-1920
DOI: https://doi.org/10.1007/s00234-018-2111-4

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

The role of cervical color Doppler ultrasound in the diagnosis of brain death

Abstract

Purpose

Methods

Results

Conclusion

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusion

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