The Use of Transcranial Doppler Ultrasound in Confirming Brain Death in the Setting of Skull Defects and Extraventricular Drains

Abstract

Transcranial Doppler ultrasound (TCD) has been used as a confirmatory test for the diagnosis of brain death (BD), but may be inaccurate in patients with a skull defect or extraventricular drain (EVD). We report three cases of patients with a skull defect or EVD in whom TCD supported a diagnosis of BD but in which the clinical examination later refuted the diagnosis. We caution against the use of TCD to confirm the diagnosis of BD in the presence of a skull defect or EVD.