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False Positive CT Angiography in Brain Death

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Abstract

Introduction

Ancillary testing is frequently required in the determination of death by brain criteria, particularly in cases in which the clinical examination is drawn into question. Newer tests, such as computed tomographic angiography (CTA), have garnered enthusiasm for their ease of performance, but have not been validated as acceptable tests compared with a gold standard.

Case

We present a case of a 31-year-old patient who was felt to have cerebral circulatory arrest on CTA, but was subsequently found to have evidence of preserved cerebral blood flow on transcranial Doppler, thus precluding the diagnosis death by brain criteria.

Discussion

CTA is not a validated confirmatory test for cerebral circulatory arrest in brain death, and may be falsely positive.

Conclusion

CTA should be studied further in comparison to validated tests, such as conventional angiography or single photon emission computed tomography (SPECT), before being accepted as a standard ancillary test in determining death by brain criteria.

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References

  1. Goudreau JL, Wijdicks EFM, Emery SF. Complications during apnea testing in the determination of brain death: predisposing factors. Neurology. 2000;55:1045–8.

    PubMed  CAS  Google Scholar 

  2. American Encephalographic Society. Guideline three: minimum technical standards for EEG recording in suspected cerebral death. J Clin Neurophysiol. 1994;11:10–3.

    Article  Google Scholar 

  3. Munari M, Zucchetta P, Carollo CT, et al. Confirmatory tests in the diagnosis of brain death: comparison between SPECT and contrast angiography. Crit Care Med. 2005;33:2068–73.

    Article  PubMed  Google Scholar 

  4. Ducrocq X, Hassler W, Moritake K, et al. Consensus opinion on diagnosis of cerebral circulatory arrest using Doppler-sonography. Task Force Group on cerebral death of the Neurosonology research group of the World Federation of Neurology. J Neurol Sci. 1998;159:145–50.

    Article  PubMed  CAS  Google Scholar 

  5. Practice parameters for determining brain death in adults (summary statement). Report of the Quality Standards Subcommittee of the American Academy of Neurology. Neurology. 1995;45:1012–4.

    Google Scholar 

  6. Qureshi AI, Kirmini JF, Xavier AR, Siddiqui AM. Computed tomographic angiography for diagnosis of brain death. Neurology. 2004;62:652–3.

    PubMed  Google Scholar 

  7. Combes J-C, Chormel A, Ricolfi F, et al. Reliability of computed tomographic angiography in the diagnosis of brain death. Transplant Proc. 2007;39:16–20.

    Article  PubMed  Google Scholar 

Download references

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Authors and Affiliations

  1. Massachusetts General Hospital, ACC 739A, MGH, 55 Fruit Street, Boston, MA, 02114, USA

    David M. Greer, Dorothea Strozyk & Lee H. Schwamm

Authors
  1. David M. Greer
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  2. Dorothea Strozyk
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  3. Lee H. Schwamm
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Corresponding author

Correspondence to David M. Greer.

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Greer, D.M., Strozyk, D. & Schwamm, L.H. False Positive CT Angiography in Brain Death. Neurocrit Care 11, 272–275 (2009). https://doi.org/10.1007/s12028-009-9220-1

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  • DOI: https://doi.org/10.1007/s12028-009-9220-1

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