Brain death: CT angiography

Case contributed by Dr Chris O'Donnell

Presentation

Out of hospital cardiac arrest. Resuscitated, not responding cerebrally, ? brain death

Patient Data

Age: 40
Gender: Female
Modality: CT

Filling of the terminal external carotid artery branches bilaterally (in the scalp) with absent filling of intracranial arteries (carotid or vertebro-basilar).  Note gross brain swelling with loss of grey/white matter, obliteration of ventricles and basal cisterns and pseudo-SAH at the skull base.  Appearances are due to marked hypoxic-ischaemic injury and indicate brain death.

Case Discussion

The absence of cerebral blood flow is an important finding - nuclear medicine scintigraphy and catheter angiography have been the mainstay of diagnostic procedures but CTA showing good filling of scalp arteries and no intracranial arterial filling is diagnostic of absent blood flow to the brain - i.e. brain death

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Case Information

rID: 49025
Case created: 6th Nov 2016
Last edited: 6th Nov 2016
Inclusion in quiz mode: Included

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