{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,23]],"date-time":"2026-07-23T23:49:36Z","timestamp":1784850576762,"version":"3.55.0"},"reference-count":40,"publisher":"FapUNIFESP (SciELO)","issue":"6","license":[{"start":{"date-parts":[[2022,11,1]],"date-time":"2022-11-01T00:00:00Z","timestamp":1667260800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2022,11,1]],"date-time":"2022-11-01T00:00:00Z","timestamp":1667260800000},"content-version":"am","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2022,11,1]],"date-time":"2022-11-01T00:00:00Z","timestamp":1667260800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Radiol Bras"],"abstract":"<jats:p>Abstract Brain death is the irreversible cessation of all brain function. Although protocols for its determination vary among countries, the concept of brain death is widely accepted, despite ethical and religious issues. The pathophysiology of brain death is related to hypoxia and ischemia in the setting of extensive brain injury. It is also related to the effects of brain edema, which increases intracranial pressure, leading to cerebral circulatory arrest. Although the diagnosis of brain death is based on clinical parameters, the use of neuroimaging to demonstrate diffuse brain injury as the cause of coma prior to definitive clinical examination is a prerequisite. Brain computed tomography (CT) and magnetic resonance imaging (MRI) demonstrate diffuse edema, as well as ventricular and sulcal effacement, together with brain herniation. Angiography (by CT or MRI) demonstrates the absence of intracranial arterial and venous flow. In some countries, electroencephalography, cerebral digital subtraction angiography, transcranial Doppler ultrasound, or scintigraphy\/single-photon emission CT are currently used for the definitive diagnosis of brain death. Although the definition of brain death relies on clinical features, radiologists could play an important role in the early recognition of global hypoxic\u2013ischemic injury and the absence of cerebral vascular perfusion.<\/jats:p>","DOI":"10.1590\/0100-3984.2022.0016","type":"journal-article","created":{"date-parts":[[2022,11,14]],"date-time":"2022-11-14T14:51:51Z","timestamp":1668437511000},"page":"365-372","source":"Crossref","is-referenced-by-count":17,"title":["The role of neuroimaging in the determination of brain death"],"prefix":"10.1590","volume":"55","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4902-0021","authenticated-orcid":false,"given":"Diogo Goulart","family":"Corr\u00eaa","sequence":"first","affiliation":[{"name":"Cl\u00ednica de Diagn\u00f3stico por Imagem,  Brazil; Universidade Federal Fluminense,  Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2021-7317","authenticated-orcid":false,"given":"Simone Rachid de","family":"Souza","sequence":"additional","affiliation":[{"name":"Universidade Federal do Rio de Janeiro,  Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3077-5101","authenticated-orcid":false,"given":"Paulo Glukhas Cassar","family":"Nunes","sequence":"additional","affiliation":[{"name":"Universidade Federal do Rio de Janeiro,  Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1158-1720","authenticated-orcid":false,"given":"Antonio Carlos","family":"Coutinho Jr.","sequence":"additional","affiliation":[{"name":"Cl\u00ednica de Diagn\u00f3stico por Imagem,  Brazil; Casa de Sa\u00fade Nossa Senhora de F\u00e1tima,  Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9771-5832","authenticated-orcid":false,"given":"Luiz Celso Hygino da","family":"Cruz Jr.","sequence":"additional","affiliation":[{"name":"Cl\u00ednica de Diagn\u00f3stico por Imagem,  Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"530","published-online":{"date-parts":[[2022,11]]},"reference":[{"key":"ref1","doi-asserted-by":"crossref","first-page":"2554","DOI":"10.1056\/NEJMcp2025326","article-title":"Determination of brain death","volume":"385","author":"Greer DM","year":"2021","journal-title":"N Engl J Med"},{"key":"ref2","doi-asserted-by":"crossref","first-page":"105465","DOI":"10.1016\/j.clineuro.2019.105465","article-title":"Brain death: radiologic signs of a non-radiologic diagnosis","volume":"185","author":"Gastala J","year":"2019","journal-title":"Clin Neurol Neurosurg"},{"key":"ref3","doi-asserted-by":"crossref","first-page":"1255","DOI":"10.1016\/j.suc.2017.07.001","article-title":"Brain death","volume":"97","author":"Drake M","year":"2017","journal-title":"Surg Clin North Am"},{"key":"ref4","doi-asserted-by":"crossref","first-page":"1911","DOI":"10.1212\/WNL.0b013e3181e242a8","article-title":"Evidence-based guideline update: determining brain death in adults: report of the Quality Standards Subcommittee of the American Academy of Neurology","volume":"74","author":"Wijdicks EFM","year":"2010","journal-title":"Neurology"},{"key":"ref5","doi-asserted-by":"crossref","first-page":"403","DOI":"10.5935\/0103-507X.20190050","article-title":"Diagnosis of brain death in Brazil","volume":"31","author":"Westphal GA","year":"2019","journal-title":"Rev Bras Ter Intensiva"},{"key":"ref6","first-page":"945","article-title":"Imaging tests in determination of brain death","volume":"52","author":"van der Lugt A","year":"2010","journal-title":"Neu-roradiology"},{"key":"ref7","first-page":"1444","article-title":"Brain death\/death by neurologic criteria determination","volume":"27","author":"Lewis A","year":"2021","journal-title":"Continuum (Minneap Minn)"},{"key":"ref8","doi-asserted-by":"crossref","first-page":"1078","DOI":"10.1001\/jama.2020.11586","article-title":"Determination of brain death\/death by neurologic criteria: the world brain death project","volume":"324","author":"Greer DM","year":"2020","journal-title":"JAMA"},{"key":"ref9","doi-asserted-by":"crossref","first-page":"515","DOI":"10.1053\/j.sult.2018.01.006","article-title":"Brain death: diagnosis and imaging techniques","volume":"39","author":"Rizvi T","year":"2018","journal-title":"Semin Ultrasound CT MR"},{"key":"ref10","doi-asserted-by":"crossref","first-page":"97","DOI":"10.1002\/msj.20104","article-title":"Pathophysiology of traumatic brain injury","volume":"76","author":"Greve MW","year":"2009","journal-title":"Mt Sinai J Med"},{"key":"ref11","doi-asserted-by":"crossref","first-page":"E1","DOI":"10.3171\/foc.2007.22.5.2","article-title":"A review of progress in understanding the pathophysiology and treatment of brain edema","volume":"22","author":"Marmarou A","year":"2007","journal-title":"Neurosurg Focus"},{"key":"ref12","series-title":"Resuscitation and stabilization of the critically ill child","first-page":"151","volume-title":"The pathophysiology of brain death and care of the potential organ donor","author":"Shemie SD","year":"2009"},{"key":"ref13","doi-asserted-by":"crossref","first-page":"205","DOI":"10.1016\/0379-0738(94)90385-9","article-title":"Brain death: neuropathological findings and forensic implications","volume":"69","author":"Oehmichen M","year":"1994","journal-title":"Forensic Sci Int"},{"key":"ref14","doi-asserted-by":"crossref","first-page":"1234","DOI":"10.1212\/01.wnl.0000289762.50376.b6","article-title":"Neuropathology of brain death in the modern transplant era","volume":"70","author":"Wijdicks EFM","year":"2008","journal-title":"Neurology"},{"key":"ref15","first-page":"20180013","article-title":"How should we use imaging in the determination of brainstem death?","volume":"1","author":"Ramachandran S","year":"2018","journal-title":"BJR Open"},{"key":"ref16","doi-asserted-by":"crossref","first-page":"139","DOI":"10.1055\/s-0035-1547533","article-title":"Brain death: the European perspective","volume":"35","author":"Citerio G","year":"2015","journal-title":"Semin Neurol"},{"key":"ref17","series-title":"Resolu\u00e7\u00e3o CFM n\u00ba 2.173\/2017. 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