Comparison of cerebral blood flow measurements by xenon computed tomography and dynamic brain scintigraphy in clinically brain dead children.

Because of the controversy over applying adult clinical and laboratory criteria to children suspected of brain death, xenon computed tomographic cerebral blood flow (XeCTCBF) and near simultaneous scintigraphy were studied in 10 children. Six met the clinical criteria, one of whom had three indeterminate scintigrams with only central flow on XeCTCBF. Another had considerable flow with scintigraphy and XeCTCBF. One with clinical and autopsy brainstem death but preserved cortical function also had flow on both. This preliminary study establishes that brain scintigraphy is occasionally hypersensitive to insufficient cerebral flow and promises more accurate early assessment with XeCTCBF. The expectation is that XeCTCBF can refine the criteria for the earlier establishment of brain death.