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Neurology India
Medknow Publications on behalf of the Neurological Society of India
ISSN: 0028-3886 EISSN: 1998-4022
Vol. 50, Num. 2, 2002, pp. 233

Neurology India, Vol. 50, No. 2, June, 2002, pp. 233

Intracranial Carotid Occlusion in Brain Death (Neuroimage)

K. Ganapathy, R. Rajaram,* J.R. Daniel**

Departments of Neurosurgery, Critical Care* and Radiology,** Sundaram Medical Foundation, Anna Nagar, Chennai - 600 040, India.

Code Number: ni02073

A 20 year old male was brought to the emergency in a deeply unconscious stage, decerebrating with a GCS of 3 and right pupil dilated. A few hours earlier, he had developed severe headache for the first time. CT showed large multiple areas of hemorrhage with isodense areas within, in the right temporoparietal region (Fig. 1). As parents insisted on further management, a selective right internal carotid angio was planned. As the right common carotid was being entered, both pupils dilated. Injection in the right common carotid artery revealed a carotid stop with no dye entering the intracranial region beyond the base of the skull (Fig. 2). The external carotid vessels were clearly visualized. By this time, the patient had all clinical features suggestive of brain death. Failure of blood to enter the intracranial circulation when intracranial pressure exceeds systemic arterial blood pressure, though described1,2 has rarely been demonstrated.

References

  1. Bradac G, Simon S : Angiography in brain death. Neuroradiology 1974; 7 : 25-28.
  2. Greitz T, Gordon E, Kolmodin G et al : Aorto-cranial and carotid angiography in determination of brain death. Neuroradiology 1973; 5 : 13-19.

Copyright 2002 - Neurology India. Also available online at http://www.neurologyindia.com


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[ni02073f2.jpg] [ni02073f1.jpg]
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