REVERSAL OF DIASTOLIC CEREBRAL BLOOD-FLOW IN INFANTS WITHOUT BRAIN-DEATH

The reversal of diastolic cerebral blood flow has been regarded as a c haracteristic waveform of brain death and a useful confirming sign, We report 2 patients who had diastolic flow reversal but survived, One, a 1-month-old boy with status epilepticus, had reversal of diastolic c erebral blood flow detected by Doppler ultrasound soon after admission , Reversal disappeared after medical management for increased intracra nial pressure and seizure control, He recovered without sequelae, The other, a 6-month-old girl with choroid plexus papilloma, had reversal of diastolic flow during abrupt clinical deterioration, Emergent surgi cal removal of the tumor was performed and she survived with hemipares is and psychomotor retardation, Our patients demonstrated that even in the presence of diastolic reversal of cerebral blood flow, prompt and effective treatment can avoid a fatal outcome.