Diagnosis of cerebral circulatory arrest by Doppler ultrasound in brain death: Do we need the cervical arteries?

Background: Doppler sonography is widely used as a confirmatory test in the diagnosis of brain death for assessment of cerebral circulatory arrest (CCA). National guidelines vary widely in the significance and the requirements for the Doppler procedure. International recommendations suggest documentation of Doppler signals typical for CCA intracranially (ic) in the middle cerebral artery (MCA) and in the distal internal carotid artery (icICA) and additionally extracranially (ec) in the cervical parts of the ICA and the vertebral arteries (VA). Evaluation of the icVA or the basilar artery (BA) is not mandatory bu…