MAGNETIC-RESONANCE-IMAGING OF BRAIN-DEATH

OBJECTIVE: To demonstrate the magnetic resonance imaging (MRI) appeara nce of the brain in patients with clinical brain death. PATIENTS AND M ETHODS: High-field (1.5-T) MRI was performed on five patients who were subsequently proven clinically brain dead. Conventional T-1-weighted and T-2-weighted imaging was performed. RESULTS: MRI exhibited similar features for all of the patients: loss of the subarachnoid spaces of the brain; slow now in the intracavernous and cervical internal caroti d arteries; and loss of flow void in the small and large intracranial arteries, as well as in the major intracranial venous sinuses. The dif ferentiation between grey and white matter in the brain was preserved, although the brain had a ''supernormal'' appearance due to the absenc e of cerebrospinal fluid and arterial pulsations. These findings have not been observed in MRI of comatose patients who were not clinically brain dead. CONCLUSION: With the advent of MRI-compatible ventilators and noninvasive monitoring, which facilitate imaging of patients under intensive care, MRI may offer another method of confirming the clinic al diagnosis of brain death.