Diagnosis of Brain Death by Common Carotid Artery Velocity Waveform Analysis

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Abstract
• In addition to neurologic criteria, some test of cessation of brain blood flow is recommended before diagnosing "brain death." Cerebral arteriography, radionuclide scintigraphy, and contrast computed axial tomography, though reliable, possess significant practical limitations. Analysis of the dimensions and contours of common carotid Doppler velocity tracings of brain-dead patients has identified qualitative and quantitative differences not only from normal subjects, but also from patients with complete atheromatous carotid occlusion and from those unconscious after brain injury. Though accurate separation was initially made using computer-assisted classification function analysis, a simplified algorithmic approach using only three velocity waveform variables has been developed without loss of accuracy. The speed, simplicity, portability, and inexpensiveness of this approach commend its use.