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2017, Number 1

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Rev Cub Med Int Emerg 2017; 16 (1)

Negative false with transcranial doppler in the brain death diagnosis. Case report

Planas OA, González RAE, Sánchez MJM, Machado CC

Language: Spanish
References: 14
Page: 1-11
PDF size: 887.42 Kb.


ABSTRACT

Introduction: The transcranial doppler (TCD) is frequently used in the diagnosis of brain death. This technique has limitations, findings in many situations false negative cases.
Methods: we studied a patient with several brain trauma, and temporoparietal subdural hematoma by acute loss of conscience in the course of a putaminal intraparenquimatose hemorrhage. A craniotomy surgery intervention in cerebral left hemisphere was realized immediately, but the patient begins with a bad evolution and was diagnosed in brain death. We realized two positive clinical evaluations with an interval of six hours between them, after that it was realized a transcranial doppler used for the exploration of the cerebral arteries of Willis circle; with a third TCD realized 6 hrs later of the second clinical evaluation.
Results: TCD showed the existence of cerebral circulatory arrest in cerebral middle artery (CMA) right and basilar artery persistent in the time, while in CMA left, in the craniotomy hemisphere side, showed a persistent velocity flow pattern in full time.
Conclusions: patient with brain death clinical diagnosis, the TCD showed a persistent velocity flow pattern in full time in CMA left, in hemisphere side with craniotomy, and existence of cerebral circulatory arrest in cerebral middle artery right and basilar artery, persistent for more than 18 hrs later. This study showed the TCD limitations in patients with diagnosis of brain death and craniotomy surgery.


REFERENCES

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