Importance of EEG as a Confirmatory Test For Brain Death Decision in Aneurysmal SAH Patients

Objective: To evaluate the efficacy of electroencephalography (EEG) and cerebral angiography (DSA) as confirmatory tests to diagnose brain death on aneurysmal subarachnoid hemorrhage (aSAH) patients. Material and Method: We prospectively evaluated all aSAH patients who were admitted to Istanbul Med...

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Main Authors: İbrahim Özkan Akıncı, Ahmet Başel, Altay Sencer, Yavuz Aras, Aydın Aydöseli, Serra Sencer, Candan Gürses, Günseli Orhun, Perihan Ergin Özcan, Lütfi Telci
Format: Article
Language:English
Published: Galenos Yayinevi 2012-12-01
Series:Türk Yoğun Bakim Derneği Dergisi
Subjects:
Online Access:http://www.yogunbakimderg.com/article_2650/Importance-Of-Eeg-As-A-Confirmatory-Test-For-Brain-Death-Decision-In-Aneurysmal-Sah-Patients
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author İbrahim Özkan Akıncı
Ahmet Başel
Altay Sencer
Yavuz Aras
Aydın Aydöseli
Serra Sencer
Candan Gürses
Günseli Orhun
Perihan Ergin Özcan
Lütfi Telci
author_facet İbrahim Özkan Akıncı
Ahmet Başel
Altay Sencer
Yavuz Aras
Aydın Aydöseli
Serra Sencer
Candan Gürses
Günseli Orhun
Perihan Ergin Özcan
Lütfi Telci
author_sort İbrahim Özkan Akıncı
collection DOAJ
description Objective: To evaluate the efficacy of electroencephalography (EEG) and cerebral angiography (DSA) as confirmatory tests to diagnose brain death on aneurysmal subarachnoid hemorrhage (aSAH) patients. Material and Method: We prospectively evaluated all aSAH patients who were admitted to Istanbul Medical Faculty Neuro-Intensive Care Unit between June 2010 and June 2011. All patients, who developed brain death according to neurologic evaluation, were evaluated again first with DSA and then EEG as confirmatory tests. Results: Of thirty seven aSAH patients admitted to our ICU during one year period, only 4 were diagnosed with clinical brain death after neurologic evaluation. First, we performed DSA which showed all had minimal cerebral blood flow. Then EEG was performed and only one of them still showed slow wave activity which contradicted brain death but other 3 had isoelectric cerebral silence which supported brain death. These 3 patients died within two days after brain death diagnosis. However, the first patient survived but Glasgow coma score was 3 and transferred to an intermediate care unit for long term care with home type ventilator. Conclusion: Unlike the common argument against confirmatory tests for brain death diagnosis, our study indicated EEG to be more reliable than DSA to confirm brain death in aSAH patients, considering that confirmatory test obligatory for brain death decisions.
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spelling doaj.art-ab7b6c5552a84f989cba7fb08af5f8222023-02-15T16:09:18ZengGalenos YayineviTürk Yoğun Bakim Derneği Dergisi2146-64162147-267X2012-12-01103869010.4274/Tybdd.33043Importance of EEG as a Confirmatory Test For Brain Death Decision in Aneurysmal SAH Patientsİbrahim Özkan Akıncı0Ahmet Başel1Altay Sencer2Yavuz Aras3Aydın Aydöseli4Serra Sencer5Candan Gürses6Günseli Orhun7Perihan Ergin Özcan8Lütfi Telci9İstanbul Üniversitesi İstanbul Tıp Fakültesi, Anesteziyoloji ve Reanimasyon Anabilim Dalı, İstanbul, Türkiyeİstanbul Üniversitesi İstanbul Tıp Fakültesi, Anesteziyoloji ve Reanimasyon Anabilim Dalı, İstanbul, Türkiyeİstanbul Üniversitesi İstanbul Tıp Fakültesi, Nöroşirürji Anabilim Dalı, İstanbul, Türkiyeİstanbul Üniversitesi İstanbul Tıp Fakültesi, Nöroşirürji Anabilim Dalı, İstanbul, Türkiyeİstanbul Üniversitesi İstanbul Tıp Fakültesi, Nöroşirürji Anabilim Dalı, İstanbul, Türkiyeİstanbul Üniversitesi İstanbul Tıp Fakültesi, Radyoloji Anabilim Dalı, İstanbul, Türkiyeİstanbul Üniversitesi İstanbul Tıp Fakültesi, Nöroloji Anabilim Dalı, İstanbul, Türkiyeİstanbul Üniversitesi İstanbul Tıp Fakültesi, Anesteziyoloji ve Reanimasyon Anabilim Dalı, İstanbul, Türkiyeİstanbul Üniversitesi İstanbul Tıp Fakültesi, Anesteziyoloji ve Reanimasyon Anabilim Dalı, İstanbul, Türkiyeİstanbul Üniversitesi İstanbul Tıp Fakültesi, Anesteziyoloji ve Reanimasyon Anabilim Dalı, İstanbul, TürkiyeObjective: To evaluate the efficacy of electroencephalography (EEG) and cerebral angiography (DSA) as confirmatory tests to diagnose brain death on aneurysmal subarachnoid hemorrhage (aSAH) patients. Material and Method: We prospectively evaluated all aSAH patients who were admitted to Istanbul Medical Faculty Neuro-Intensive Care Unit between June 2010 and June 2011. All patients, who developed brain death according to neurologic evaluation, were evaluated again first with DSA and then EEG as confirmatory tests. Results: Of thirty seven aSAH patients admitted to our ICU during one year period, only 4 were diagnosed with clinical brain death after neurologic evaluation. First, we performed DSA which showed all had minimal cerebral blood flow. Then EEG was performed and only one of them still showed slow wave activity which contradicted brain death but other 3 had isoelectric cerebral silence which supported brain death. These 3 patients died within two days after brain death diagnosis. However, the first patient survived but Glasgow coma score was 3 and transferred to an intermediate care unit for long term care with home type ventilator. Conclusion: Unlike the common argument against confirmatory tests for brain death diagnosis, our study indicated EEG to be more reliable than DSA to confirm brain death in aSAH patients, considering that confirmatory test obligatory for brain death decisions.http://www.yogunbakimderg.com/article_2650/Importance-Of-Eeg-As-A-Confirmatory-Test-For-Brain-Death-Decision-In-Aneurysmal-Sah-PatientsBrain deathconfirmatory testelectroencephalographysubarachnoid hemorrhage
spellingShingle İbrahim Özkan Akıncı
Ahmet Başel
Altay Sencer
Yavuz Aras
Aydın Aydöseli
Serra Sencer
Candan Gürses
Günseli Orhun
Perihan Ergin Özcan
Lütfi Telci
Importance of EEG as a Confirmatory Test For Brain Death Decision in Aneurysmal SAH Patients
Türk Yoğun Bakim Derneği Dergisi
Brain death
confirmatory test
electroencephalography
subarachnoid hemorrhage
title Importance of EEG as a Confirmatory Test For Brain Death Decision in Aneurysmal SAH Patients
title_full Importance of EEG as a Confirmatory Test For Brain Death Decision in Aneurysmal SAH Patients
title_fullStr Importance of EEG as a Confirmatory Test For Brain Death Decision in Aneurysmal SAH Patients
title_full_unstemmed Importance of EEG as a Confirmatory Test For Brain Death Decision in Aneurysmal SAH Patients
title_short Importance of EEG as a Confirmatory Test For Brain Death Decision in Aneurysmal SAH Patients
title_sort importance of eeg as a confirmatory test for brain death decision in aneurysmal sah patients
topic Brain death
confirmatory test
electroencephalography
subarachnoid hemorrhage
url http://www.yogunbakimderg.com/article_2650/Importance-Of-Eeg-As-A-Confirmatory-Test-For-Brain-Death-Decision-In-Aneurysmal-Sah-Patients
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