SynthesisNeurocritical care2014
Computed tomography angiography in the diagnosis of brain death: a systematic review and meta-analysis.
Synthesis in Neurocritical care, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 22 papers, 1 of them a synthesis that pooled it.
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Who cites it
22 citing papers in PubMed, 1 synthesis or guideline pooled it, 62 citations in OpenAlex.
- Diagnostic accuracy of ancillary tests for death by neurologic criteria: a systematic review and meta-analysis.Canadian journal of anaesthesia = Journal canadien d'anesthesie · 2023Pooled it
- Computed Tomography Angiography as Ancillary Testing for Death Determination by Neurologic Criteria: A Technical Review.Tomography (Ann Arbor, Mich.) · 2024Review
- Computed tomography angiography in the diagnosis of brain death: Implementation and results in Germany.European journal of neurology · 2024Article
- The value of computed tomography angiography in predicting the surgical effect and prognosis of severe traumatic brain injury.Scientific reports · 2024Article
- Pictorial Review on Imaging Findings in Cerebral CTP in Patients with Acute Stroke and Its Mimics: A Primer for General Radiologists.Diagnostics (Basel, Switzerland) · 2023Review
- Cerebral blood vessels and perfusion in the pediatric brain death: five cases studied by neuroimaging.Neuroradiology · 2022Article
- Brain death: a clinical overview.Journal of intensive care · 2022Review
- Computed tomography angiography scoring systems and the role of skull defects in the confirmation of brain death.Scientific reports · 2021Article
- Article
- Assessment of Cerebral Circulatory Arrest via CT Angiography and CT Perfusion in Brain Death Confirmation.Korean journal of radiology · 2021Article
- Neurological determination of death in isolated brainstem lesions: A case report to highlight the issues involved.Journal of the Intensive Care Society · 2020Article
- The observation period after clinical brain death diagnosis according to ancillary tests: differences between supratentorial and infratentorial brain injury.Journal of neurology · 2019Observational
- Computed Tomography Perfusion is a Useful Adjunct to Computed Tomography Angiography in the Diagnosis of Brain Death.Clinical neuroradiology · 2019Article
- 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
- Accuracy of Computed Tomographic Perfusion in Diagnosis of Brain Death: A Prospective Cohort Study.Medical science monitor : international medical journal of experimental and clinical research · 2018Article
- Ancillary Studies in Evaluating Pediatric Brain Death.Journal of pediatric intensive care · 2017Review
- Renaissance of criticism on the concept of brain death--the role of legal medicine in the context of the interdisciplinary discussion.International journal of legal medicine · 2016Article
- Brain death determination: still a lot to learn, still a lot to do….Neurocritical care · 2014Article
Corrections and comments
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Authors and funding
2 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundPhysiological instability and confounding factors may interfere with the clinical diagnosis of brain death. Computed tomography angiography (CTA) has been suggested as a potential ancillary test for confirmation of brain death, but its diagnostic accuracy remains unclear.
methodsWe searched MEDLINE, EMBASE, and CENTRAL for studies comparing CTA with other accepted methods of diagnosing brain death (clinical or radiographic). Summary estimates of diagnostic accuracy were computed using random effects models. Subgroup analyses and meta-regression were performed to assess associations between CTA sensitivity and study or patient characteristics.
resultsTwelve studies, involving 541 patients, were included. If the CTA criterion for brain death was complete lack of opacification of intracranial vessels, then the pooled sensitivity was 62 % (50-74 %) for venous phase and 84 % (75-94 %) for arterial phase imaging. The sensitivity of CTA was higher when the criterion for brain death involved absence of opacification of internal cerebral veins, either alone (99 %, 97-100 %) or in combination with lack of flow to the distal middle cerebral artery branches (85 %, 77-93 %). CTA sensitivity was not influenced by different reference standards (clinical vs. radiographic) or predominant diagnostic category (stroke vs. brain trauma). Specificity of CTA could not be adequately determined from the existing data.
conclusionMany patients who progress to brain death by accepted clinical or radiographic criteria have persistent opacification of proximal intracranial vessels when CTA is performed. The specificity of CTA in the diagnosis of brain death has not been adequately assessed. Routine use of CTA as an ancillary test in the diagnosis of brain death is therefore not recommended until diagnostic criteria have undergone further refinement and prospective validation. Absence of opacification of the internal cerebral veins appears to be the most promising angiographic criterion.
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