E. Vicenzini 1, P. Pulitano 1, R. Cicchetti 2, P. Papov 2, G. Spadetta 3, M. Rocco 3, V. Di Piero 1, G. L. Lenzi 1, O. Mecarelli 1
1 Department of Neurology and Psychiatry,
2 Neonatal Intensive Care Unit,
3 Transplant Coordinator, Intensive Care Unit. Sapienza, University of Rome – Rome, Italy

Objective: Transcranial Doppler is sensitive technique for the diagnosis of cerebral circulatory arrest in brain death, when specific patterns such as reverberant flow and short systolic spikes are observed in intracranial arteries. These patterns are related to the occurrence of brain swelling in the inextensible skull, resulting in transformation from a normal “low-resistance” into a “high-resistance” brain parenchyma. In infants, the non-ossified fontanelles initially compensates for intracranial hypertension. We describe TCD patterns in infants with brain death, different from adults, with the hemodynamic modifications induced by anterior fontanelle compression.