ABSTRACTS XVI ALASBIMN CONGRESS  NUCLEAR MEDICINE 1999.

14. NEUROLOGY-PSYCHIATRY

14.1 USEFULNESS OF SPECT AS SUBSIDIARY EXAMINATION IN THE DETERMINATION OF BRAIN DEATH IN CHILDREN

C.S.KUROKAWA, M.M.SEVILLANO, M.L.V.CASTIGLIONI, G. ALONSO, A.BARBIERI.

HOSPITAL SAO PAULO - UNIFESP - BRAZIL

ddi@epm.br

The diagnosis of Brain Death (BD) is usually done through clinical criteria, electroencephalography and brain's blood flow analysis studies. Cintilography differs from others methods in that it evaluate the blood perfusion in the brain in a safe manner, easy to understand.

OBJECTIVES:

To evaluate the presence of cerebral blood perfusion in children with evidence of BD. We performed a prospective study, in 13 children with ages between 3mo to 13 years, suspected to have brain death, between October 1996 and January 1998. We used hypotension, hypothermia, sedation, use of neuromuscular blockade, exogenous intoxication and cervical lesion as exclusion criteria. All patients were submitted to brain SPECT. Eight subjects also did EEG and 9 patients were subjected to head CT. After 20 to 30 minutes of the injection of ECD(etilenodiscisteindietilesther) labeled with 99TC we obtained the images through a gamma camera. Nine patients died and the SPECT showed no cerebral perfusion in 6; in the others SPECT showed areas of hypoperfusion of several degrees of magnitude. Four patients survived (30.7%), the SPECT showed evidence of brain perfusion in all of then EEG was done in three patients and demonstrated a suppression-seizure pattern in one of the cases and a suppression pattern in the other. We concluded that SPECT is a reliable non invasive and safe method to help in the diagnosis of brain death.

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