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Scintigraphic Evaluation of Brain Death: Significance of Sagittal Sinus Visualization

Section of Nuclear Medicine and Section of Neurosurgery, Boston City Hospital, Boston University School of Medicine, Boston, Massachusetts

Correspondence: For reprints contact: V.W. Lee, MD, Section of Nuclear Medicine, c/o 10 Mohawk Dr., Framingham, MA 01701.

ABSTRACT

Radiotracer scintigraphy has been commonly used in this country to confirm and document the clinical diagnosis of brain death. Whether the presence of radiotracer activity in the region of sagittal venous sinus (SVS) represents actual blood flow to the brain in the absence of demonstrable cerebral arterial flow remains a controversial issue. Our retrospective study was performed to review the significance of such sagittal tracer activity. Of the 53 patients showing no cerebral arterial flow, 26 showed tracer activity in the region of SVS. The clinical status, EEG findings, and outcome of all 53 patients were the same irrespective of the presence or absence of SVS tracer activity. We conclude that the mere presence of SVS in the absence of demonstrable cerebral arterial flow activity is not clinically significant and does not contradict the diagnosis of brain death.

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				J. D. Morenski, J. J. Oro, J. D. Tobias, and A. Singh Determination of Death by Neurological Criteria J Intensive Care Med, July 1, 2003; 18(4): 211 - 221. [Abstract] [PDF]