, Volume 61, Issue 2, pp 137–145 | Cite as

The role of cervical color Doppler ultrasound in the diagnosis of brain death

  • Alessandro Pedicelli
  • Margherita Bartocci
  • Emilio Lozupone
  • Francesco D’Argento
  • Andrea Alexandre
  • Giuseppe Garignano
  • Ciro D’Alò
  • Viola Giacobbe
  • Iacopo ValenteEmail author
  • Cesare Colosimo
Diagnostic Neuroradiology



Brain death (BD) is defined as the irreversible destruction of all brain functions. It is usually diagnosed through a clinical examination, but in certain circumstances, ancillary examinations (such as digital subtraction angiography (DSA), transcranial color Doppler (TCD), computed tomography angiography (CTA), magnetic resonance angiography (MRA), or radionuclide scanning) are required as confirmatory tests. In many countries, cervical color Doppler sonography (CCD) is not recognized as a valid test.

The aim of our study is to assess its accuracy as a non-invasive, inexpensive, and easily available examination to determine cerebral circulatory arrest (CCA).


We performed a retrospective study in which 123 patients with clinical diagnosis of BD underwent bedside cervical color Doppler as an additional examination for CCA assessment. We compared these cervical color Doppler findings with the results of validated ancillary tests such as CTA, TCD, and DSA.


Cervical color Doppler exams showed a sensitivity of 78% (96/123 patients) in detecting CCA compared to standard ancillary tests. Twenty-seven patients showed a persistent diastolic flow in one or two of the four arterial vessels examined and thus considered as false negatives.


Our results show that cervical color Doppler may become a reliable and safe technique in detecting CCA, which can shorten the time for declaring brain death. In particular, in patients lacking good bone windows at transcranial color Doppler, cervical color Doppler of the cervical internal carotids and vertebral arteries could be recommended to increase the sensitivity of transcranial color Doppler, or as an alternative bedside examination.


Brain death Cerebral circulatory arrest Transcranial color Doppler Cervical color Doppler Ancillary test 


Compliance with ethical standards


No funding was received for this study.

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. For this type of study formal consent is not required.

Informed consent

For this type of retrospective study formal consent is not required.


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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2018

Authors and Affiliations

  • Alessandro Pedicelli
    • 1
  • Margherita Bartocci
    • 2
  • Emilio Lozupone
    • 1
  • Francesco D’Argento
    • 1
  • Andrea Alexandre
    • 1
  • Giuseppe Garignano
    • 3
  • Ciro D’Alò
    • 4
    • 5
  • Viola Giacobbe
    • 6
  • Iacopo Valente
    • 1
    Email author
  • Cesare Colosimo
    • 1
    • 3
  1. 1.UOC Radiologia e Neuroradiologia, Dipartimento di diagnostica per immagini, radioterapia oncologica ed ematologiaFondazione Policlinico Universitario A. Gemelli IRCCSRomeItaly
  2. 2.UO Radiologia, Dipartimento di radiologia e diagnostica per immaginiFondazione Poliambulanza Istituto OspedalieroBresciaItaly
  3. 3.Istituto di RadiologiaUniversità Cattolica del Sacro CuoreRomeItaly
  4. 4.UOC Anestesia, Rianimazione, Terapia Intensiva e Tossicologia Clinica, Dipartimento di scienze dell’emergenza, anestesiologiche e della rianimazioneFondazione Policlinico Universitario A. Gemelli IRCCSRomeItaly
  5. 5.Istituto di Anestesiologia e RianimazioneUniversità Cattolica del Sacro CuoreRomeItaly
  6. 6.Medical Science DivisionGuerbetVillepinteFrance

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