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Transcranial pulsed Doppler ultrasound findings in brain stem death

Transcranial pulsed Doppler ultrasound findings in brain stem death
Transcranial pulsed Doppler ultrasound findings in brain stem death

Data are presented from transcranial insonation of the middle cerebral artery (MCA) performed at intervals in 23 unconscious children for whom the outcome was subsequently poor. Once an MCA signal had been observed over a 30 minute period with time averaged velocity less than 10 cm s1 and/or a direction of flow index, DFI, defined as 1 minus the ratio of reverse to forward flow of less than 08, recovery to forward flow throughout diastole was never observed and no patient recovered brain stem reflexes. Recovery of forward flow in diastole, and of brain stem function, was seen in cases with time averaged MCA velocity in the range 10 to 25 cm s1 and with reverse flow but a DFI of greater than 0-8 for short periods of time. All but one of the 13 children fulfilling clinical criteria for brain stem death had MCA signals with time averaged velocity of less than 10cm/s and DFI of less than 0-8. This type of signal was not observed in five children who were left in a persistent vegetative state.

0022-3050
1504-1513
Kirkham, F.J.
1dfbc0d5-aebe-4439-9fb2-dac6503bcd58
Levin, S.D.
45779258-c1d5-4c50-b3bb-b71624f2401a
Padayachee, T.S.
31708c93-2a10-4e77-ab16-ff1178424dd3
Kyme, M.C.
26e75274-cf86-4239-9e4c-2f03c3f830a5
Neville, B.G R
f955179d-844d-49cb-8d88-0eb6a1f76d8a
Gosling, R.G.
5a770b77-41fc-43f2-90fa-f56b9eae30f0
Kirkham, F.J.
1dfbc0d5-aebe-4439-9fb2-dac6503bcd58
Levin, S.D.
45779258-c1d5-4c50-b3bb-b71624f2401a
Padayachee, T.S.
31708c93-2a10-4e77-ab16-ff1178424dd3
Kyme, M.C.
26e75274-cf86-4239-9e4c-2f03c3f830a5
Neville, B.G R
f955179d-844d-49cb-8d88-0eb6a1f76d8a
Gosling, R.G.
5a770b77-41fc-43f2-90fa-f56b9eae30f0

Kirkham, F.J., Levin, S.D., Padayachee, T.S., Kyme, M.C., Neville, B.G R and Gosling, R.G. (1987) Transcranial pulsed Doppler ultrasound findings in brain stem death. Journal of Neurology, Neurosurgery, and Psychiatry, 50 (11), 1504-1513. (doi:10.1136/jnnp.50.11.1504).

Record type: Article

Abstract

Data are presented from transcranial insonation of the middle cerebral artery (MCA) performed at intervals in 23 unconscious children for whom the outcome was subsequently poor. Once an MCA signal had been observed over a 30 minute period with time averaged velocity less than 10 cm s1 and/or a direction of flow index, DFI, defined as 1 minus the ratio of reverse to forward flow of less than 08, recovery to forward flow throughout diastole was never observed and no patient recovered brain stem reflexes. Recovery of forward flow in diastole, and of brain stem function, was seen in cases with time averaged MCA velocity in the range 10 to 25 cm s1 and with reverse flow but a DFI of greater than 0-8 for short periods of time. All but one of the 13 children fulfilling clinical criteria for brain stem death had MCA signals with time averaged velocity of less than 10cm/s and DFI of less than 0-8. This type of signal was not observed in five children who were left in a persistent vegetative state.

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Published date: November 1987

Identifiers

Local EPrints ID: 429770
URI: https://eprints.soton.ac.uk/id/eprint/429770
ISSN: 0022-3050
PURE UUID: 34f8e8b9-14aa-4c91-ab8e-5c9b7b8ed819
ORCID for F.J. Kirkham: ORCID iD orcid.org/0000-0002-2443-7958

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Date deposited: 05 Apr 2019 16:30
Last modified: 13 Jun 2019 00:37

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Contributors

Author: F.J. Kirkham ORCID iD
Author: S.D. Levin
Author: T.S. Padayachee
Author: M.C. Kyme
Author: B.G R Neville
Author: R.G. Gosling

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