Diffusion-Weighted Magnetic Resonance Imaging in Brain Death
- 1 February 2000
- journal article
- case report
- Published by Ovid Technologies (Wolters Kluwer Health) in Stroke
- Vol. 31 (2), 539-542
- https://doi.org/10.1161/01.str.31.2.539
Abstract
Background —Traditionally the diagnosis of brain death is established on the basis of a combination of clinical signs and paraclinical methods. Diffusion-weighted MRI is a new method sensitive to cerebral ischemia. Its value in brain death has not been demonstrated until now. Case Description —A patient was referred to MRI with suspicion of a brain stem stroke. Echo-planar whole-brain, multislice, diffusion-weighted MRI was performed in addition to conventional sequences and MR angiography sequences. In addition to the extensive bilateral hyperintensities observed on T2-weighted images, diffusion-weighted MRI showed diffuse hyperintensities involving both hemispheres as well as a severe drop in the apparent diffusion coefficient in both affected hemispheres. There was also transtentorial herniation with compression of the brain stem as well as absence of flow voids on the T2-weighted images and absence of intracranial vessels on MR angiography. On the basis of the clinical and imaging findings, it was concluded that the patient was in a state of brain death. The patient died the same day. Conclusions —With the use of new fast techniques such as diffusion-weighted imaging, now MRI can not only display anatomic changes associated with severe brain suffering but can also demonstrate ultrastructural changes secondary to brain death and differentiate them from edematous changes seen on T2-weighted images.This publication has 14 references indexed in Scilit:
- Magnetic Resonance Imaging of Acute StrokeJournal of Cerebral Blood Flow & Metabolism, 1998
- Ischemic lesion volumes in acute stroke by diffusion‐weighted magnetic resonance imaging correlate with clinical outcomeAnnals of Neurology, 1997
- Time course of the apparent diffusion coefficient (ADC) abnormality in human strokeNeurology, 1997
- MR Detection of Cortical Spreading Depression Immediately after Focal Ischemia in the RatJournal of Cerebral Blood Flow & Metabolism, 1996
- Evolution of Regional Changes in Apparent Diffusion Coefficient during Focal Ischemia of Rat Brain: The Relationship of Quantitative Diffusion NMR Imaging to Reduction in Cerebral Blood Flow and Metabolic DisturbancesJournal of Cerebral Blood Flow & Metabolism, 1995
- Determining brain death in adults [RETIRED]Neurology, 1995
- Fast magnetic resonance diffusion‐weighted imaging of acute human strokeNeurology, 1992
- Early detection of regional cerebral ischemia in cats: Comparison of diffusion‐ and T2‐weighted MRI and spectroscopyMagnetic Resonance in Medicine, 1990
- MRI demonstrates descending transtentorial herniationNeurology, 1988
- Electroencephalographic Activity After Brain DeathArchives of Neurology, 1987