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Brain perfusion scintigraphy, Brain Death

Nieves NMN - MedPix (2001)

View Article: MedPix Image - MedPix Topic

Affiliation: Tripler Army Medical Center

ABSTRACT

Clinical History: 41 year old male with large right intracranial bleed from a MCA aneurysm rupture. Clinically dead. Findings: Brain perfusion scintigraphy was performed utilizing 99m Technetium DTPA, IV. The blood flow images show lack of significant intracranial arterial flow. Subsequent delayed images do not demonstrate radiotracer within the major intracranial venous sinuses. Instead, there is diversion of blood flow into the extracranial circulation, which results in a "Hot Nose Sign" (increase in flow to the face/nose). There is no brain parenchymal uptake. These findings are suggestive of the clinical diagnosis of brain death. Discussion: Brain death is a clinical diagnosis. Nuclear Medicine scintigrams are used, in conjunction to clinical findings, to corroborate the clinical determination. This study is particularly useful when organ donation or when cessation of life support is being considered. Among the radiopharmaceuticals that can be used to perform brain perfusion are 99mTc-DTPA, 99m Tc-glucoheptonate, and 99mTc pertechnetate.(EDITOR'S NOTE: Lipophilic rCBF tracers like Tc-99m HMPAO may also be used and are, in most instances, preferable). It should be noted that some instutions may utilize a scalp tourniquet in adult patients, as it minimizes the flow through the external arterial circulation. An adequate bolus is required, and there should be symmetrical flow to the common carotid arteries. Diagnostic findings are provided above.

No MeSH data available.


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Brain perfusion scintigraphy, Brain Death

Nieves NMN - MedPix (2001)

See discussion
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=MPX2684&req=5

MPX2684_synpic1010: See discussion

View Article: MedPix Image - MedPix Topic

Affiliation: Tripler Army Medical Center

ABSTRACT

Clinical History: 41 year old male with large right intracranial bleed from a MCA aneurysm rupture. Clinically dead. Findings: Brain perfusion scintigraphy was performed utilizing 99m Technetium DTPA, IV. The blood flow images show lack of significant intracranial arterial flow. Subsequent delayed images do not demonstrate radiotracer within the major intracranial venous sinuses. Instead, there is diversion of blood flow into the extracranial circulation, which results in a "Hot Nose Sign" (increase in flow to the face/nose). There is no brain parenchymal uptake. These findings are suggestive of the clinical diagnosis of brain death. Discussion: Brain death is a clinical diagnosis. Nuclear Medicine scintigrams are used, in conjunction to clinical findings, to corroborate the clinical determination. This study is particularly useful when organ donation or when cessation of life support is being considered. Among the radiopharmaceuticals that can be used to perform brain perfusion are 99mTc-DTPA, 99m Tc-glucoheptonate, and 99mTc pertechnetate.(EDITOR'S NOTE: Lipophilic rCBF tracers like Tc-99m HMPAO may also be used and are, in most instances, preferable). It should be noted that some instutions may utilize a scalp tourniquet in adult patients, as it minimizes the flow through the external arterial circulation. An adequate bolus is required, and there should be symmetrical flow to the common carotid arteries. Diagnostic findings are provided above.

No MeSH data available.