The Hollow Skull: A Sign of Brain Death in Tc-99m HM-PAO Brain Scintigraphy

Abstract

The advantage of Tc-99m HM-PAO, a newly introduced compound for brain perfusion imaging, is illustrated in three patients with suspicion of brain death. With Tc-99m HM-PAO, the carotid flow study is not essential, as it is in the Tc-99m pertechnetate carotid angiogram; planar images are equally useful; and there is no need for SPECT images. For the diagnosis of brain death, Tc-99m HM-PAO can be injected in the intensive care unit and planar images can be obtained at a later time using a mobile camera or whenever the patient can be moved to the nuclear medicine department.