Diagnostic ultrasound ( PDFDrive )

CHAPTER 47 Doppler Sonography of the Brain in Children 1617
A
B
C
D
E
R
FIG. 47.22 Cerebral Edema Progressing to Brain Death in
1 1 2 -Year-Old Child With Near-Drowning. (A) CT scan shows
diffuse cerebral edema. (B) MCA Doppler shows an elevated RI
of 0.82. (C) MCA Doppler 2 days later shows that RI has decreased
to a more normal range of 0.62 with treatment. (D) However,
MCA Doppler 4 days later shows decreased velocity and reversal
of diastolic low, consistent with greatly diminished cerebral perfusion.
(E) 99m Tc-DTPA brain scan at this time shows no cerebral
perfusion, consistent with brain death. (With permission from
Seibert JJ. Doppler evaluation of cerebral circulation. In Dieckmann
RA, Fiser DHB, Selbst SM, editors. Illustrated textbook of pediatric
emergency and critical care procedures. St. Louis: Mosby–Year
Book; 1997. 52 )