Sammanfattning
We present a case where a patient, following a supratentorial subarachnoid haemorrhage, was scheduled to be an organ donor. Some doubt was raised whether the patient had a total brain infarction even though the clinical diagnosis of brain death was unambiguous and supported by transcranial Doppler ultrasonography. The reason for this was a never before described phenomenon with a long lasting therapy-resistant hypertension in the donor. A succeeding cerebral angiography confirmed the clinical diagnosis and the procedure were successfully executed. This case report shows that clinical investigation for total brain infarction was reliable in this case with a supratentorial cause to the cerebral herniation and with an unexpected pronounced hypertension.
However, as an experienced transplantation team questioned the clinical diagnosis we recommend cerebral angiography to be performed in cases with unusual donor reactions.