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August 6, 1982

Cerebral Radionuclide Angiography: Its Application in the Diagnosis of Brain Death

JAMA. 1982;248(5):591-592. doi:10.1001/jama.1982.03330050073040

CEREBRAL radionuclide angiography or angioscintigraphy was once a common diagnostic procedure, generally as an integral part of nuclear brain scanning. In recent years, however, computed tomography has largely replaced brain scanning, and cerebral angioscintigraphy is being used only as a noninvasive alternative to contrast angiography, particularly in situations where the dynamic status of circulation is under question, but the anatomic detail is of less concern. A prime example of such a situation is suspected brain death.

In some 30 states of the Union, a patient is considered legally dead if his or her brain is dead. Brain death means the irreversible cessation of all functions of the brain, including those of the brainstem. Several sets of diagnostic criteria for brain death have been published.1-4 With few exceptions, the general requirements are as follows: (1) the patient is in deep coma; (2) spontaneous respiration is absent; (3) all reflexes, especially