The Correlation of Brain Tomography Angio and Apnea Test in Cerebral Death Diagnosis

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IntroductionDeath is an irreversible biological event containing the permanent suspension of organisms critical functions as a whole.[1][2] For a brain death (BD) diagnosis, an exact clinical examination and apnea test of the patient are required. If there are some barriers in apnea test, adjuvant tests are applied. Cerebral Angiography, Cerebral Sintigraphy, Electroencephalography and Transcranial Doppler Ultrasonagraphy are defined as adjuvant tests in American Neurology Academy (AAN) directions. Computer Tomography Angiography (CTA) is a non-invasive and common research that can claim intracanial blood flow is absent or reduced severely but it is not in adjucant tests which AAN admit as it is lack of enough reliability.[3] In this study we have aimed assess the accord of CTA with clinical examinations and apnea tests to diagnose BD.MethodologyOur method is to assess retrospectively the apnea test CTA accord of 28 patients who have been diagnosed with cerebral death in last 5 years in Burdur Public Hospital. The data obtained from hospital’s file records have been assessed.FindingsTwenty-eight patients diagnosed with cerebral death have been examined as a result of retrospective 5 years data. These patients have been diagnosed via neurologic examination and apnea test, in addition, CTA has been applied for each of them. After clinical assessments and apnea tests it has been observed that 22 patients are synonymous with CTA applied to them. Four patients have been diagnosed with BD after examination and apnea test, as for CTA examination and tests have been repeated because of suspicious lesions but the result has been the same BD for them. Apnea test for two patients couldn’t be applied (hemodynamic failure due to hypoxia); they have been diagnosed after CTA and examination.ResultsBrain death is a state that can be diagnosed after apnea test and neurologic examination. Most of the time additional tests can be needed to support the diagnosis; also there are many other factors: laws of the nations, physicians approaches, and religious believes etc. Cerebral Angiography is the golden standard to diagnose the BD, however each clinic cannot reach this application. We are of the opinion that CTA can be used as an additional test although it’s not among the tests approved by AAN.[3]References1. Wijdicks EFM. Brain Death, Lippincott Williams andWilkins, Philadelphia 2001. p.1752. Wahlster S, Wijdicks EF, Patel PV, et al. Brain death declaration: Practices and perceptions worldwide. Neurology 2015; 84:18703. Jackson J, Willmarth-Stec M, Shutter L; American Academy of Neurology. Update of clinical practic1e guidelines for brain death determination in an academic health center. J Neurosci Nurs. 2015 Feb;47(1):44–50

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