Transcranial Doppler sonography (TCD) can detect the cerebral circulatory arrest (CCA) in brain-dead patients with a high level of specificity and sensitivity. Reverberating flow, systolic spikes and no flow signal are the three typical waveforms found on the TCD examination of patients with CCA. The typical waveforms should be monitored and confirmed for 30 minutes in the anterior (bilateral middle cerebral or siphon internal carotid arteries) and posterior (basilar artery or bilateral vertebral arteries) circulation territories for the confirmatory diagnosis of brain death. The examiner need to be careful in interpreting TCD results because false positive or negative TCD findings are not rarely found in the circumstances of clinical practice in brain-injured patients, although TCD having a high diagnostic accuracy for CCA.

Journal of Neurosonology 5(1):19-23, 2013
Key Words: Transcranial doppler, Cerebral circulatory arrest, Brain death