Observational studyAJNR. American journal of neuroradiology2019
Impact of Skull Defects on the Role of CTA for Brain Death Confirmation.
Observational study in AJNR. American journal of neuroradiology, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers.
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Who cites it
9 citing papers in PubMed, 18 citations in OpenAlex.
- Brain Perfusion Scintigraphy in the Diagnostic Toolbox for the Confirmation of Brain Death: Practical Aspects and Examination Protocol.Diagnostics (Basel, Switzerland) · 2025Article
- Diagnostic Sensitivity of the Revised Venous System in Brain Death in Children.Tomography (Ann Arbor, Mich.) · 2025Article
- Computed tomography angiography in the diagnosis of brain death: Implementation and results in Germany.European journal of neurology · 2024Article
- Measuring brain perfusion by CT or MR as ancillary tests for diagnosis of brain death: a systematic review and meta-analysis.BJR open · 2024Article
- Unilateral eye opening as spinal motor reflex in brain death.Acta neurologica Belgica · 2023Article
- Computed Tomography Angiography (CTA) in Selected Scenarios with Risk of Possible False-Positive or False-Negative Conclusions in Diagnosing Brain Death.Life (Basel, Switzerland) · 2022Review
- Cerebral blood vessels and perfusion in the pediatric brain death: five cases studied by neuroimaging.Neuroradiology · 2022Article
- Computed tomography angiography scoring systems and the role of skull defects in the confirmation of brain death.Scientific reports · 2021Article
- Assessment of Cerebral Circulatory Arrest via CT Angiography and CT Perfusion in Brain Death Confirmation.Korean journal of radiology · 2021Article
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Authors and funding
4 authors at 3 institutions in 3 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
background and purposeIntracranial pressure modifications caused by a skull defect, such as craniectomy or craniotomy, may change the hemodynamics and decrease the accuracy of CTA to confirm brain death. This study aimed to evaluate the impact of a skull defect and the interpretation criteria of images on this diagnostic test. MATERIALS AND
methodsA series of consecutive patients with a clinical diagnosis of brain death underwent CTA (case group), while the control group comprised patients with acute ischemic stroke in the same period. CTA criteria adopted to confirm brain death were the absence of opacification of the M4 branches and internal cerebral veins. The evaluation also included the presence of "stasis filling." Cases were stratified as intact skull, craniotomy, and craniectomy. Three neuroradiologists evaluated all examinations independently.
resultsIn the case group, according to the Frampas criteria, the sensitivity of CTA to confirm brain death was 95.5% in patients with intact skull, 87.5% with craniotomy, and 60% with craniectomy. False-negative diagnoses of brain death were 15.6%, related to stasis filling in 71.4% (
conclusionsCTA had a high diagnostic accuracy and reproducibility to confirm brain death in patients with an intact skull. The modified Frampas criteria increased the sensitivity of CTA, particularly in patients with a skull defect. A concurrent skull defect, especially craniectomy, can decrease the sensitivity of CTA to confirm brain death.
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