Assessing the Consistency of Clinical Diagnosis and Ancillary Tests For Brain Death

Yıl 2019, Cilt: 43 Sayı: 1, 29 - 33, 01.07.2019

Tuğhan Utku Süha Bozbay Seval Ürkmez Eren Fatma Akçıl Oktay Demirkıran Yalım Dikmen

Öz

DOI: 10.26650/cjm.2019.43.42

Objective: Brain death (BD) implies the
permanent absence of cerebral and brainstem functions.  It should be shown that there is no blood
flow in all brain regions even besides the brainstem by using the confirmatory
tests. We aimed to evaluate the incompatibility to diagnosis of BD by clinical
and ancillary tests (computed tomographic angiography (CTA), magnetic resonance
imaging angiography (MRIA), transcranial Doppler ultrasonography (TCD-USG),
electroencephalography (EEG)).

Methods: The patients admitted to our
intensive care unit between 2012-2018 have been evaluated retrospectively.
Twenty two patients who were assessed as BD, and additionally 12 of them had
ancillary tests for BD for certain diagnosis investigated. Demographic data,
causes of BD, and the follow ups were recorded for all patients.

Results: Twelve patients were diagnosed as
BD. The reasons leading to BD were intracranial hemorrhage, cardiac arrest,
intracranial tumours, pulmonary embolism, aneurysmal hemorrhage, menengitis,
subarachnoid hemorrhage. The mean age was 40.86±15.62 years, the mean APACHE II
score was 28.23±16.33. Brain death was diagnosed by clinically in 10 patients,
and 12 patients evaluated by ancillary tests.

Conclusion: Brain death can be diagnosed
based on clinical criteria, but in somehow confirmative tests may be necessary.
Clinically diagnosing of BD is not always consistent with CTA, and procedure is
needed to be repeated or other further techniques have to be used for
confirmation.

Cite this article as: Utku T, Bozbay S,
Ürkmez S, Akçıl EF, Demirkıran O, Dikmen Y. Assessing the consistency of
clinical diagnosis and ancillary tests for brain death. Cerrahpasa Med J 2019;
43(1): 29-33.

Anahtar Kelimeler

Brain death, ancillary tests, computed tomographic angiography

Beyin ölümü için klinik tanı ve yardımcı testlerin tutarlılığı

Öz

DOI: 10.26650/cjm.2019.43.42

Amaç: Beyin ölümü (BÖ), beyin ve beyin sapı
işlevlerinin kalıcı yokluğunu ifade eder. Doğrulayıcı testler kullanılarak
beyin sapı dışında bile tüm beyin bölgelerinde kan akışı olmadığı
gösterilmelidir. BÖ tanısının uyumsuzluğunu klinik ve yardımcı testler
(bilgisayarlı tomografik anjiyografi (BTA), manyetik rezonans görüntüleme
anjiyografisi (MRIA), transkranial Doppler ultrasonografi (TKD-USG),
elektroensefalografi (EEG)) ile değerlendirmeyi amaçladık.

Yöntemler: 2012-2018 yılları arasında yoğun
bakım ünitemize başvuran hastalar retrospektif olarak değerlendirildi. BÖ için
22 hasta değerlendirildi ve ayrıca 12 tanesinde, BÖ tanısında kesin tanı için
yardımcı testler yapıldı. Tüm hastalar için demografik veriler, BÖ’nün
nedenleri ve takipleri kaydedildi.

Bulgular: On iki hastaya BÖ tanısı kondu.
BÖ’ye neden olan nedenler intrakraniyal kanama, kardiyak arrest, intrakraniyal
tümörler, pulmoner emboli, anevrizmal kanama, menenjit, subaraknoid kanama idi.
Yaş ortalaması 40,86±15,62, ortalama APACHE II skoru 28,23±16,33 idi. Beyin
ölümü 10 hastada klinik olarak teşhis edildi ve 12 hasta yardımcı testlerle
değerlendirildi.

Sonuç: Beyin ölümü klinik kriterlere göre
teşhis edilebilir, ancak bir şekilde doğrulayıcı testler gerekli olabilir.
BÖ’nün klinik olarak tanısı her zaman BTA ile tutarlı değildir ve tekrarlanması
için prosedür gereklidir veya başka ileri teknikler kullanılmalıdır.

Cite this article as: Utku T, Bozbay S,
Ürkmez S, Akçıl EF, Demirkıran O, Dikmen Y. Assessing the consistency of
clinical diagnosis and ancillary tests for brain death. Cerrahpasa Med J 2019;
43(1): 29-33.

Anahtar Kelimeler

Beyin ölümü, yardımcı tanı testleri, bilgisayarlı tomografik anjiyografi

Kaynakça

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