Persistent cerebral blood flow by transcranial Doppler ultrasonography in an asphyxiated newborn meeting brain death diagnosis: case report and review of the literature

Abstract

We want to illustrate the difficulty of establishing a brain death diagnosis in newborn children and how an easy and useful tool, the transcranial Doppler ultrasonography, can leave an unexpected result that complicates the process despite the rest of the diagnostic tests. We describe a 36-week gestation newborn male who was diagnosed of brain death after asphyxiated and offered for donation. After initial stabilization at admission, we established brain death diagnosis by checking and meeting every criterion. The donation process was complicated because of persistent blood flow on transcranial Doppler ultrasonography. Transcranial Doppler ultrasonography is a very useful method to assess cerebral blood flow. However, caution and individualization are needed when interpreting this complementary exam, especially in highly conflictive situations like brain death diagnosis.