Determination of cerebral perfusion by means of planar brain scintigraphy and 99mTc-HMPAO in brain death, persistent vegetative state and severe coma.

Autor:	Schlake, H., Böttger, I., Grotemeyer, K., Husstedt, I., Brandau, W., Schober, O., Schlake, H P, Böttger, I G, Grotemeyer, K H, Husstedt, I W
Předmět:	AMINES AUDITORY evoked response BLOOD-brain barrier BRAIN death BRAIN stem CEREBRAL circulation COMA COMPARATIVE studies DIFFERENTIAL diagnosis ELECTROENCEPHALOGRAPHY RESEARCH methodology MEDICAL cooperation NEUROLOGIC examination ORGANIC compounds RADIONUCLIDE imaging RESEARCH SOMATOSENSORY evoked potentials EVALUATION research GLASGOW Coma Scale
Zdroj:	Intensive Care Medicine; Feb1992, Vol. 18 Issue 2, p76-81, 6p
Abstrakt:	A total of 24 patients with clinical evidence of brain death (n = 17), severe coma (n = 2; GCS approximately 3) and apallic syndrome (n = 4) underwent a comparative investigation with 99mTc-HMPAO brain scintigraphy, EEG, auditory and somatosensory evoked potentials. Accompanied by EEG and evoked potentials, brain scintigraphy enabled confirmation of cerebral death in 15/17 patients. In one case clinical examination and evoked potentials suggest brain death, but cerebral perfusion and EEG were normal ("brain stem death"). One patient with evidence of cerebral death in clinical examination, brain scintigraphy and evoked potentials, showed questionable focal EEG activity; however, autopsy revealed intravital autolysis of the entire brain. All patients with apallic syndrome and deep coma showed a distinct cerebral perfusion, but gross EEG abnormalities; evoked potentials were delayed or absent. Planar scintigraphy with 99mTc-HMPAO appears to be superior to neurophysiological techniques discriminating patients with agonal cerebral dysfunction from those with brain death. [ABSTRACT FROM AUTHOR]
Databáze:	Complementary Index
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