Ramachandran Sanjeev, Venkatesh Harish, Foley Robert William
University Hospitals of Leicester NHS Trust, Leicester, UK.
Royal Berkshire NHS Foundation Trust, Reading, UK.
BJR Open. 2018 Nov 7;1(1):20180013. doi: 10.1259/bjro.20180013. eCollection 2019.
Brainstem death is defined as the "irreversible cessation of brainstem function", either due to primary intracranial events or extracranial factors such as hypoxia. The importance of accurate and timely diagnosis of brainstem death in critical care should not be understated, as it allows the withdrawal of treatment when it is no longer deemed to beneficial. Additionally, it may facilitate the process of organ donation. Overall, the diagnosis of brainstem death has four common principles across the world: (1) neurological criteria based on clinical assessment; (2) evidence of irreversible brain damage from known aetiology; (3) demonstrating an absence of a reversible cause; and (4) the use of ancillary studies. The latter in particular has been a controversial issue, with much debate continuing on how imaging should be used. We discuss three key questions surrounding the role of imaging in the diagnosis of brainstem death as well as important issues the radiology community should consider.
脑干死亡被定义为“脑干功能的不可逆性停止”，其原因要么是原发性颅内事件，要么是诸如缺氧等颅外因素。在重症监护中准确及时诊断脑干死亡的重要性不容小觑，因为这能在治疗不再被认为有益时停止治疗。此外，它可能有助于器官捐献过程。总体而言，脑干死亡的诊断在全球有四个共同原则：（1）基于临床评估的神经学标准；（2）已知病因导致的不可逆脑损伤的证据；（3）证明不存在可逆病因；（4）使用辅助检查。后者尤其具有争议性，关于如何使用影像学检查仍有很多争论。我们讨论围绕影像学在脑干死亡诊断中的作用的三个关键问题以及放射学界应考虑的重要问题。
