Analysis of the use of computerized angiotomography for diagnosis of brain death: A Systematic Review

Background: Brain death (BD) can be described as a complete and irreversible loss of brain function caused by the cessation of both brain and spinal cord activity. The diagnosis of this condition is mainly clinical, although it can be used with ancillary tests such as Computed Tomography Angiography (CTA) to increase the accuracy of the diagnosis. Also, the countries’ protocol of BD diagnosis vary regarding the ancillary tests, and there is no consensus on this topic in literature. Objective: The aim of this study is to answer the question if CTA is a sensitive ancillary test for the diagnosis of brain death. Methods: In this systematic review, we evaluate the articles published on PubMed/MEDLINE until July 16, 2024. Data of brain death causes, accordance percentage of CTA corroborating BD and the clinical BD diagnosis, CTA scores and which arteries and vein had lack of opacification were analyzed. Methodological quality was assessed by QUADAS-2. Results: The searches retrieved 2187 records, of which 30 publications were selected for full-text screening. 6 studies were included, with 1346 patients evaluated. The accordance percentage of CTA corroborating BD and the clinical BD diagnosis varied from 100% (3 studies), 97% (1 study), 94,2% (1 study) and 1 study divided in 52,4% confirming BD diagnosis with 47,6% indicating BD diagnosis. Conclusion: CTA is a promising method for BD diagnosis, nevertheless there are disagreements regarding its use, and still more studies are needed.