Common confirmatory tests in Brain Death

Cerebral angiography

  • Contrast medium under high pressure in both anterior and posterior circulation injections
  • No intracerebral filling at the level of the carotid or vertebral artery entry to the skull
  • Patent external carotid circulation
  • Possible delayed filling of the superior longitudinal sinus


  • Minimum of eight scalp electrodes
  • Interelectrode dependencies should be between 100 and 10,000
  • Integrity of the entire recording system should be tested
  • There should be no electroencephalographic reactivity to intense somatosensory or audiovisual stimuli

Transcranial Doppler ultrasonography

  • Bilateral insonation
  • The probe is placed at the temporal bone above the zygomatic arch or the vertebrobasilar arteries through the suboccipital transcranial window
  • The abnormalities should include a lack of diastolic or reverberating flow, small systolic peaks in early systole, and a lack of flow found by the investigator who previously demonstrated normal velocities

Cerebral scintigraphy (technetium Tc 99m hexametazime)

  • Injection of isotope within 30 minutes of reconstitution
  • Static image of 500,000 counts at several time intervals: immediately, between 30 and 60 minutes, and at 2 hours.