Đánh giá kết quả siêu âm doppler xuyên sọ trong chẩn đoán chết não tại bệnh viện Trung Ương Huế

SUMMARY

Background: Although the clinical examination has the most important role and documentation of the clinical signs of brain death are very uniform, it is necessary to use technical confirmatory tests to corroborate the clinical signs such as Transcranial Doppler ultrasonography (TCD) and Electroencephalography (EEG). The current study examined (1) Hemodynamic of cerebral arteries in 16 death brain cases (2) the role of TCD in confirmation of brain death.

Subjects and methods:16 patients clinical brain deathwere included in the study. The following TCD findings were accepted as confirmatory of brain death when they were found at least one of two within the same examination: (1) brief systolic forward flow or systolic spikes and diastolic reverse flow or no diastolic flow, (2) Vmax <10cm/s or no demonstrable flow in a patient in whom flow had been clearly documented in a previous TCD examination.

Results: All of cases were confirmed as brain death on TCD. 14/16 patients (87.5%) performed the waveform abnormality, the rest was found decreasing velocity or missing the blood flow on TCD.

Conclusion: The sensitivity of TCD is increased with repeat examinations and should be repeated in cases in which systolodiastolic forward flow is demonstrated after the first TCD. TCD may prolong or shorten the time to declaration of brain death. The necessity of demonstrating cerebral circulatory arrest in patients with clinical brain death is debatable.

Key words: brain death, doppler ultrasonography.