Reversal of diastolic cerebral blood flow in infants without brain death

Pediatr Neurol. 1994 Nov;11(4):337-40. doi: 10.1016/0887-8994(94)90013-2.

Abstract

The reversal of diastolic cerebral blood flow has been regarded as a characteristic waveform of brain death and a useful confirming sign. We report 2 patients who had diastolic flow reversal but survived. One, a 1-month-old boy with status epilepticus, had reversal of diastolic cerebral blood flow detected by Doppler ultrasound soon after admission. Reversal disappeared after medical management for increased intracranial pressure and seizure control. He recovered without sequelae. The other, a 6-month-old girl with choroid plexus papilloma, had reversal of diastolic flow during abrupt clinical deterioration. Emergent surgical removal of the tumor was performed and she survived with hemiparesis and psychomotor retardation. Our patients demonstrated that even in the presence of diastolic reversal of cerebral blood flow, prompt and effective treatment can avoid a fatal outcome.

Publication types

  • Case Reports

MeSH terms

  • Blood Flow Velocity / physiology
  • Brain / blood supply*
  • Brain Damage, Chronic / diagnostic imaging*
  • Brain Damage, Chronic / physiopathology
  • Brain Damage, Chronic / therapy
  • Choroid Plexus Neoplasms / diagnostic imaging
  • Choroid Plexus Neoplasms / physiopathology
  • Choroid Plexus Neoplasms / therapy
  • Diastole / physiology*
  • Female
  • Follow-Up Studies
  • Glioma / diagnostic imaging
  • Glioma / physiopathology
  • Glioma / therapy
  • Humans
  • Infant
  • Male
  • Neurologic Examination
  • Status Epilepticus / diagnostic imaging
  • Status Epilepticus / physiopathology
  • Status Epilepticus / therapy
  • Ultrasonography, Doppler, Transcranial*
  • Vascular Resistance / physiology