Uematsu S, Smith T D, Walker A E
J Neurosurg. 1978 Jun;48(6):866-75. doi: 10.3171/jns.1978.48.6.0866.
Conclusive diagnosis of brain death can be made by the demonstration of prolonged cessation of cerebral blood flow. This report describes a simple method to determine the presence or absence of the blood flow in the brain by recording the pulsatile midline echo on one channel of the electroencephalogram (EEG) or on any four-channel monitoring system in the intensive care unit. A firm transducer holder has been developed to eliminate artifacts caused by transducer motion, The pulsations of the midline echo are assumed to be the result of displacement of the midline structures by the arterial injection of each cardiac systole. Thus, the absence of these midline pulsatile echoes correlates with the absence of cerebral blood flow and, if the absence persists over 30 minutes in the presence of normal blood pressure, then the result is brain death. Twenty-eight cases of clinical brain death with electrocerebral silence of EEG and 18 obtained patients with various types of cerebral pathology were examined by the echo-pulsation technique. Twenty-six of the 28 cases showed no pulsation of the midline echo. The validity of the technique was documented in four cases by four-vessel cerebral angiogram.
脑死亡的确切诊断可通过证明脑血流长期停止来做出。本报告描述了一种简单的方法，通过在脑电图（EEG）的一个通道或重症监护病房的任何四通道监测系统上记录中线搏动回声，来确定脑内血流的有无。已经开发出一种稳固的换能器固定器，以消除由换能器移动引起的伪影。中线回声的搏动被认为是每次心脏收缩时动脉注入导致中线结构移位的结果。因此，这些中线搏动回声的缺失与脑血流的缺失相关，如果在血压正常的情况下这种缺失持续超过30分钟，那么结果就是脑死亡。通过回声搏动技术对28例脑电图呈脑电静息的临床脑死亡病例和18例患有各种类型脑部病变的患者进行了检查。28例病例中有26例中线回声无搏动。该技术的有效性在4例病例中通过四血管脑血管造影得到了证实。
