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Brain death

Dr Jeremy Jones and Dr Gagandeep Singh et al.

Brain death is usually assessed clinically, and the criteria vary from country to country.

Radiology may be used when clinical tests are impossible to perform, e.g ocular trauma precluding brainstem function assessment. Most tests rely on absence of cerebral blood flow as a surrogate for brain death. This can be assessed by a number of modalities including:

cerebral perfusion: nuclear medicine
- flow images are obtained in the anterior projection; delayed images follow 5 to 10 minutes after the injection
- hot nose sign: increased ECA perfusion to the nasal region (a cute sign but of no real diagnostic value) ¹
angiography: no forward flow above the terminal ICA

References

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1. Huang AH. The hot nose sign. Radiology. 2005;235 (1): 216-7. doi:10.1148/radiol.2351030537 - Pubmed citation