TCD and brain death

Q:  Change of pattern in blood flow on Transcranial Doppler (TCD) precedes hours before clinical determination of brain death?

A) True

B) False

Answer:   A

The presence of reverberating flow, systolic spikes, or absence of flow in the basilar and both middle cerebral arteries observed in two examinations is highly specific for the prediction of brain death. This reading can be difficult for novices. The objective of this question is to emphasize the utility of TCD in the determination of brain death as a non-invasive, bedside, and quickly available modality. It is interesting to note that changes in TCD blood flow can be preceded in patients with brain death's clinical diagnosis by 6–40 hours.

#neurology

#end-of life-care

Reference:

Li Y, Liu S, Xun F, Liu Z, Huang X. Use of Transcranial Doppler Ultrasound for Diagnosis of Brain Death in Patients with Severe Cerebral Injury. Med Sci Monit. 2016;22:1910-1915. Published 2016 Jun 6. doi:10.12659/msm.899036