Brain Death – a New Protocol Proposed

Overview

In the Czech Republic, brain death can be pronounced after two panangiography series done with 30 minutes time interval in-between. Thisexamination has a high falsely negative results, even though the patient is apparently brain dead, according to the clinical examination. Radio-opaquefluid frequently flows above skull base to the intracranial part of the vasculature; sometimes, ophthalmic artery can be visualized. The intracranialfilling of the vasculature can be affected by previous decompressive craniectomy.Based on the authors’ experience, there are recommended possible changes in the evaluation of brain death. This should be stated on clinicalexamination and single panangiography. The perfusion in the vertebral arteries should be limited to the extracranial part only. In the carotid arteries,perfusion should be allowed also for ophthalmic artery, but not to the Willis circle arteries and branches.

Key words:
brain panangiography – clinical examination