Magnetic Resonance Imaging in Confirmation of Brain Death

Brain death is defined as an irreversible cessation of all cerebral and brain stem functions despite the maintenance of cardiopulmonary functions by artificial means. The importance of early diagnosis of brain death has increased particularly with advances in organ transplantation. Our purpose was to determine the value of MRI as an ancillary test and to compare it with routine EEG and radionuclide studies. Eleven patients who met the clinical criteria of brain death were imaged both with radionuclide studies (RCA and SPECT) and MRI. The diagnosis of all the patients was verified by both studies. Eight of the patients underwent EEG and the results of seven were consistent with the previously confirmed diagnosis while there was one false negative result. MR proved to be as successful as radionuclide studies in the confirmation of brain death while it seemed to be more valuable than EEG in this limited study group. MR imaging also provided detailed structural information, findings and evidence to shed light on the etiology and give clues as to cerebral blood supply. MRI can be the modality of choice especially in cases of unknown etiology.