ArticleDeutsches Arzteblatt international2012
Technical aids in the diagnosis of brain death: a comparison of SEP, AEP, EEG, TCD and CT angiography.
Article in Deutsches Arzteblatt international, 2012. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 32 papers, 2 of them syntheses that pooled it.
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Who cites it
32 citing papers in PubMed, 2 syntheses or guidelines pooled it, 65 citations in OpenAlex.
- Diagnostic Accuracy of Transcranial Doppler for Brain Death Confirmation: Systematic Review and Meta-Analysis.AJNR. American journal of neuroradiology · 2016Pooled it
- Computed tomography angiography in the diagnosis of brain death: a systematic review and meta-analysis.Neurocritical care · 2014Pooled it
- Use of transcranial Doppler to determine brain death or death by neurologic criteria in children: a narrative review.World journal of pediatrics : WJP · 2026Review
- Is a Second Transcranial Doppler Study Needed to Confirm Neurocirculatory Arrest?Neurocritical care · 2025Article
- Computed tomography angiography in the diagnosis of brain death: Implementation and results in Germany.European journal of neurology · 2024Article
- [Prospective investigation of extracranial duplex sonography for the detection of cerebral circulatory arrest in patients with irreversible loss of brain function].Der Nervenarzt · 2023Article
- [Diagnosis of brain death in Germany-Implementation of the guidelines of the German Medical Association].Der Nervenarzt · 2023Article
- Cerebral blood vessels and perfusion in the pediatric brain death: five cases studied by neuroimaging.Neuroradiology · 2022Article
- Exclusive color-coded duplex sonography of extracranial vessels reliably confirms brain death: A prospective study.Frontiers in neurology · 2022Article
- Pediatric brain death certification: a narrative review.Translational pediatrics · 2021Review
- Advanced Bioelectrical Signal Processing Methods: Past, Present and Future Approach-Part II: Brain Signals.Sensors (Basel, Switzerland) · 2021Review
- Implementation of Computed Tomography Angiography (CTA) and Computed Tomography Perfusion (CTP) in Polish Guidelines for Determination of Cerebral Circulatory Arrest (CCA) during Brain Death/Death by Neurological Criteria (BD/DNC) Diagnosis Procedure.Journal of clinical medicine · 2021Article
- Controversies in Brain Death Declaration: Legal and Ethical Implications in the ICU.Current treatment options in neurology · 2020Review
- The observation period after clinical brain death diagnosis according to ancillary tests: differences between supratentorial and infratentorial brain injury.Journal of neurology · 2019Observational
- Impact of Skull Defects on the Role of CTA for Brain Death Confirmation.AJNR. American journal of neuroradiology · 2019Observational
- The role of cervical color Doppler ultrasound in the diagnosis of brain death.Neuroradiology · 2019Article
- Article
- The Role of Neuroimaging in the Determination of Brain Death.Journal of neuroimaging : official journal of the American Society of Neuroimaging · 2018Article
- An institutional study of awareness of brain-death declaration among resident doctors for cadaver organ donation.Indian journal of anaesthesia · 2017Article
- Brain Computed Tomography Angiography as an Ancillary Test in the Confirmation of Brain Death.Cureus · 2017Article
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Authors and funding
11 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundThe use of technical aids to confirm brain death is a controversial matter. Angiography with the intra-arterial administration of contrast medium is the international gold standard, but it is not allowed in Germany except in cases where it provides a potential mode of treatment. The currently approved tests in Germany are recordings of somatosensory evoked potentials (SSEP), brain perfusion scintigraphy, transcranial Doppler ultrasonography (TCD), and electroencephalography (EEG). CT angiography (CTA), a promising new alternative, is being increasingly used as well.
methodsIn a prospective, single-center study that was carried out from 2008 to 2011, 71 consecutive patients in whom brain death was diagnosed on clinical grounds underwent recording of auditory evoked potentials (AEP) and SSEP as well as EEG, TCD and CTA.
resultsThe validity of CTA for the confirmation of brain death was 94%; the validity of the other tests was: 94% for EEG, 92% for TCD, 82% for SSEP, and 2% for AEP. In 61 of the 71 patients (86%), the EEG, TCD and CTA findings all accorded with the clinical diagnosis. The diagnosis of brain death was established beyond doubt in all patients.
conclusionIn this study, the technical aids yielded discordant results in 14% of cases, necessitating interpretation by an expert examiner. The perfusion tests, in particular, can give false-positive results in patients with large cranial defects, skull fractures, or cerebrospinal fluid drainage. In such cases, electrophysiologic tests or a repeated clinical examination should be performed instead. CTA is a promising, highly reliable new method for demonstrating absent intracranial blood flow. In our view, it should be incorporated into the German guidelines for the diagnosis of brain death.
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