In 9 patients with the clinical diagnosis of brain death, a HM-PAO-SPECT was performed to document the arrest of cerebral circulation. Besides brain-stem areflexia, negative apnea-test and an observation time of at least 12 hours neurophysiological examinations (EEG and evoked potentials) were performed. In 4 cases, an additional arterial digital subtraction angiography proved the arrest of cerebral circulation shown in SPECT. In 5 cases, there was cortical low activity still present in EEG with negative SPECT. HM-PAO-SPECT seems to be a reliable noninvasive radiological method in the determination of brain death. It is especially helpful in cases with persisting focal cortical EEG-activity.
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