Brain death in children: clinical, neurophysiological and radioisotopic angiography findings in 125 patients

The objective of this study was to determine the main clinical, neurophysio logical and angiographic findings in brain death (BD) in children seen at t he Institute Nacional de Pediatria, a third-level facility in Mexico City, between 1991 and 1996. The following variables were retrospectively analyze d: sex, age, etiology, associated morbidity, duration of stay in hospital, and the results of two of three confirmatory studies (electroencephalogram, evoked potentials, radioisotopic angiography). In all, 125 patients were s tudied [78 male; median age 2 years (range: 18 days to 17 years)]. The most frequent etiology was infection (34%); 57% of the children developed assoc iated morbidity. In 111 of 122 patients electrocerebral silence was observe d; 100 of 107 had brain stem and somatosensory evoked po tentials affording conclusive evidance of ED; and 83 of 90 patients had a positive radioisoto pic angiography indicating ED. In 76 patients all three confirmatory studie s were performed: for 15 there was at least one false-negative test result. Our age cohort showed a predominance of children less than 2 years old. ED etiologies in developing countries differ from those reported in developed countries.