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Journal of Korean Neurosurgical Society 1990;19(4): 481-486.
Diagnostic Criteria for Determination of Brain Death Using the Transcranial Doppler(TCD).
Yang Kwon, Seung Chul Rhim, Byung Duk Kwun, Chang Jin Whang
Department of Neurological Surgery, Asan Medical Center, College of Medicine, Ulsan University, Korea.
ABSTRACT
It is generally known that demonstration of absence of cerebral blood flow is necessary to confirm brain death. Transcranial Doppler(TCD) is an accurate method of monitoring the blood flow velocities of the cerebral vessels. We performed transcranial doppler(TCD) examinations on 15 patients in brain death. Anterior circulation was examined through the temporal window or transorbital window and basilar arteries were examined through the suboccipital window. All of the patients fulfilled the criteria for determination of brain death by clinical criteria, EEG and/or Brainstem Auditory Evoked Response(BAER) or clinical criteria alone, were mechanically ventilated. A TCD waveform abnormality consisting of reversed diastolic components was found in all brain death patients. The net flow velocities of <10cm/sec were present in all brain death patients. TCD may be a rapid and convenient alternative to cerebral angiography for confirming brain death when institutional protocols require such confirmation.
Key Words: Transcranial Doppler(TCD); EEG; BAER; Reversed diastolic components; Net flow velocity
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