The role of color duplex sonography in the brain death diagnostics

In Russia brain death diagnostic is still under great public attention. In such environment confirmatory tests are absolutely necessary. Aim of our study is to investigate the cerebral blood flow in brain death using color-coded duplex sonography. The sonographic study of 20 patients with brain death was performed and included transcranial and extracranial color duplex sonography. All patients were untrepanized. The following parameters were measured – presence of reverberating flow, Vmax ranges.

Results: At baseline TCDS revealed both MCA in all patients, and the BA in 18 patients. Oscillating flow with Vmax −32 ± 12 sm/s in MCA was found. Reverberating flow in the proximal segment of ICA and in the V2 segment of VA was found in all patients. Vmax ranges were 96 ± 27 sm/s in ICA and 58 ± 17 sm/s in VA. After 6 h TCDS was successful in 16 patients. In all of 16 cases blood flow in the MCA as a systolic peak or reverberating flow was detected. Basilar system study was successful in 12 cases. In all vessels blood flow was as systolic peaks.

Extracranial ICA and VA were visualized in all cases. In the ICA and V2, V3 segments of the VA reverberating flow were detected. Vmax was 47 ± 25 sm/s in ICA and 35 ± 17 sm/s in VA. In BD color duplex scanning reveals oscillating flow or systolic spikes in distal ICA, VA, intracranial vessels. In TCDS, the most common finding is MCA with reverberating flow. The optimum combination is extracranial and intracranial scanning in the early stages of BD.