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All Journal Jurnal Ilmu Kedokteran dan Kesehatan Indonesia
Bowo Adiyanto
Universitas Gadjah Mada
Health Professions Public Health

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Transcranial Doppler (TCD) Examination is One of the Ancillary Investigations Used to Establish the Diagnosis of Brain Death Crodia Hernandes; Bowo Adiyanto
Jurnal Ilmu Kedokteran dan Kesehatan Indonesia Vol. 6 No. 2 (2026): Juli: Jurnal Ilmu Kedokteran dan Kesehatan Indonesia
Publisher : Lembaga Pengembangan Kinerja Dosen

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.55606/jikki.v6i2.11219

Abstract

Background: The determination of brain death relies primarily on clinical neurological assessment; however, ancillary investigations are often required when standard examination or apnea testing cannot be fully performed. Transcranial Doppler (TCD) ultrasonography offers a noninvasive bedside method to assess cerebral hemodynamics and may provide supportive evidence of severely impaired cerebral perfusion. Case Presentation: We report a serial case of critically ill patients with severe neurological impairment following cardiac arrest, in whom TCD was performed as part of the evaluation for suspected brain death. TCD examinations focused on intracranial arterial flow patterns, particularly within the middle cerebral artery. The observed waveforms demonstrated high-resistance pulsatile flow with markedly reduced diastolic velocities, reflecting impaired cerebral perfusion rather than immediate cerebral circulatory arrest. Serial neurological deterioration and neuroimaging findings were consistent with severe hypoxic–ischemic brain injury. Conclusion: Transcranial Doppler ultrasonography serves as a valuable ancillary tool in the assessment of suspected brain death by providing real-time information on cerebral blood flow dynamics. Although TCD should not replace clinical criteria, its bedside availability and ability to demonstrate evolving high-resistance flow patterns make it a useful supportive modality in selected clinical situations.
Co-Authors Crodia Hernandes