Brain Death
Gabriel Soudry, MD
J Stevan Nagel, MD
June 16, 1994
Presentation
A 47-year-old man was working on his boat when he fell to the ground
unconscious. He was taken to a local emergency ward where a head CT
showed a large brainstem hemorrhage. The next day a brain death
evaluation was begun and a brain scan was ordered.
Imaging Findings
Flow Study
Planar Views
On Tc-99m HMPAO brain scintigraphy, the initial anterior flow study and
subsequent planar views in the anterior and lateral projections
demonstrate no appreciable intracerebral blood flow in either the
internal carotid or posterior cerebral circulations.
Diagnosis
Brain death
Discussion
Brain death is characterized by absent cerebral blood flow and global
cerebral infarction. The brain scan can be used to confirm the
absence of cerebral perfusion in suspected brain death. The study
an be performed with intravenous bolus injection of Tc-99m HMPAO.
Flow images are obtained in the anterior projection. Delayed images
follow 5 to 10 minutes after the injection. Anterior and both lateral
planar views are usually obtained. The diagnosis of brain death can
be made only if intracranial activity is absent.
References
1. Palmer EL, Scott JA, Strauss HW. Practical Nuclear Medicine.
Philadelphia: WB Saunders, 1992:371, 373.
Dear Visitors: Nothing on this World Wide Web site should be considered medical advice. Only your own doctor can help you make decisions
about your medical care. It is not the policy of the Brigham and Women's Hospital Department of Radiology to provide consultation on the World
Wide Web or via e-mail. If you have a specific medical question or are seeking medical care, please call the Brigham and Women's Hospital
toll-free physician referral line at 1-800-294-9999.
Is this a mirrored page?
The official homepage of the BrighamRAD Teaching Case Database is http://brighamrad.harvard.edu/education/online/tcd/tcd.html
Contact the BrighamRAD
Design Team for additional information about this website.
Flow Study
Planar Views