Brain perfusion scans to diagnose brain death: more than meets the eye.

摘要

An "empty skull"-this is the dramatic visual image we see in patients who have "no flow" on a brain perfusion scan. It is created by the persistence of flow to the skin and extracerebral structures of the head with an absence of flow to the brain. It is such a compelling image that one might be tempted to agree with Tibballs (1) that perfusion scanning should become the gold standard for diagnosing brain death. In his words, "A test of brain blood perfusion not only obviates the need for the apneic oxygenation test but also shows that, if the brain is not perfused, it is certain to have no remaining function and thus satisfies the legal requirement for 'irreversible cessation of all brain function.'"