Validity of Radionuclide Cerebral Angiography for Diagnosing Brain Death in Infants

  • Julius M. Goodman
  • Larry L. Heck
  • Stephen K. Nugent
  • Michael S. Turner


Since 1969, we have been using intravenous (IV) radionuclide cerebral angiography (RCA) as a confirmatory test for brain death in both children and adults (Goodman and Heck, 1977; Goodman et al., 1969, 1985). However, a recent highly respected consensus report (Report of the Medical Consultants on the Diagnosis of Death, 1981) has advised caution in using adult-based criteria for determining brain death in children, implying that a young child with a severe neurological insult may have greater recovery potential than an adult in a similar situation. In order to respond to concerns raised about the validity of RCA in diagnosing brain death in very young patients, we have reviewed our recent results with this technique in infants under 2 years with suspected brain death.


Sudden Infant Death Syndrome Pediatric Intensive Care Unit Brain Death Venous Sinus Radionuclide Angiography 


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. Ad Hoc Committee on Brain Death, The Children’s Hospital, Boston, 1987, Determination of brain death, J. Pediatr. 110: 15–19.CrossRefGoogle Scholar
  2. Ashwal, S., and Schneider, S., 1979, Failure of electroencephalography to diagnose brain death in comatose children, Ann. Neurol. 6: 512–517.PubMedCrossRefGoogle Scholar
  3. Drake, B., Ashwal, S., and Schneider, S., 1986, Determination of cerebral death in the pediatric intensive care unit, Pediatrics 78: 107–112.PubMedGoogle Scholar
  4. Fackler, J. C., and Rogers, M. C., 1987, Is brain death really cessation of all intracranial function?, J. Pediatr. 110: 84–86.PubMedCrossRefGoogle Scholar
  5. Goodman, J. M., and Heck, L. L., 1977, Confirmation of brain death at bedside by isotope angiography, JAMA 238: 966–968.PubMedCrossRefGoogle Scholar
  6. Goodman, J. M., Mishkin, F. S., and Dyken, M., 1969, Determination of brain death by isotope angiography, JAMA 209: 1869–1897.PubMedCrossRefGoogle Scholar
  7. Goodman, J. M., and Heck, L. L., and Moore, B. D., 1985, Confirmation of brain death with portable isotope angiography: A review of 204 consecutive cases, Neurosurgery 16: 492–497.PubMedCrossRefGoogle Scholar
  8. Holzman, B. H., Curless, R. G., Sfakianakis, G. N., Ajmone-Marsan, C., and Montes, J. E., 1983, Radionuclide cerebral perfusion scintigraphy in determination of brain death in children, Neurology (NY) 33: 1027–1031.Google Scholar
  9. Korein, J., 1986, Brain states: Death, vegetation, and life, in: Anesthesia and Neurosurgery ( J. E. Cottrell and H. Turndorf, eds), pp. 293–351, CV Mosby, St. Louis.Google Scholar
  10. Leestma, J. E., Hughes, J. R., and Diamond, E. R., 1984, Temporal correlates in brain death. EEG and clinical relationships to the respirator brain, Arch. Neurol. 41: 147–152.PubMedCrossRefGoogle Scholar
  11. Lynn, J., 1983, Diagnosis of brain death. (Letter.) JAMA 250: 612.PubMedCrossRefGoogle Scholar
  12. Mishkin, F., 1975, Determination of cerebral death by radionuclide angiography, Radiology 115: 135–137PubMedGoogle Scholar
  13. Nordlander, S., Wiklund, P. E., and Asard, P. E., 1973, Cerebral angioscintigraphy in brain death and in coma due to drug intoxication, J. Nucl. Med. 14: 856–857.PubMedGoogle Scholar
  14. Report of the Medical consultants on the Diagnosis of Death to the President’s Commission for the Study of Ethical Problems in Medicine and Behavioral Research, 1981, Guidelines for the determination of death, JAMA 246: 2184–2186.CrossRefGoogle Scholar
  15. Schwartz, J. A., Baxter, J., Brill, D. and Burns, J. R., 1983, Radionuclide cerebral imaging confirming brain death, JAMA 249: 246–247.PubMedCrossRefGoogle Scholar
  16. Schwartz, J. A., Baxter, J., and Brill, D. R., 1984, Diagnosis of brain death in children by radionuclide cerebral imaging, Pediatrics 73: 14–18.PubMedGoogle Scholar
  17. Tsai, S. H., Cranford, R. E., Rockswold, G. L., and Koehler, S., 1982, Cerebral radionuclide angiography. Its application in the diagnosis of brain death, JAMA 248: 591–592.PubMedCrossRefGoogle Scholar

Copyright information

© Plenum Publishing Corporation 1989

Authors and Affiliations

  • Julius M. Goodman
    • 1
    • 2
  • Larry L. Heck
    • 3
  • Stephen K. Nugent
    • 4
  • Michael S. Turner
    • 1
    • 2
  1. 1.Indianapolis Neurosurgical Group, Neuroscience SectionMethodist Hospital of IndianaIndianapolisUSA
  2. 2.Division of NeurosurgeryIndiana University Medical CenterIndianapolisUSA
  3. 3.Section of Nuclear RadiologyMethodist Hospital of IndianaIndianapolisUSA
  4. 4.Pediatric Intensive Care UnitMethodist Hospital of IndianaIndianapolisUSA

Personalised recommendations