Brain death imaging is often a diagnostic challenge. Cerebral angiosci
ntigraphy is extensively used for this analysis, but this test does no
t allow the perfusion evaluation of the posterior fossa. The authors r
eport a case in which a SPECT study showed persistence of blood frow i
n infratentorial structures with total absence of cerebral (supratento
rial) perfusion. This finding excluded the diagnosis of brain death.