RT Journal Article SR Electronic T1 Brain dead or not? CT angiogram yielding false-negative result on brain death confirmation JF BMJ Case Reports FD BMJ Publishing Group Ltd SP bcr2012007754 DO 10.1136/bcr-2012-007754 VO 2013 A1 Robyn Johnston A1 Chandrasekaran Kaliaperumal A1 Gerald Wyse A1 George Kaar YR 2013 UL http://casereports.bmj.com/content/2013/bcr-2012-007754.abstract AB We describe a case of severe traumatic brain injury with multiple facial and skull fractures where CT angiogram (CTA) failed to yield a definite result of brain death as an ancillary test. A 28-year-old man was admitted following a road traffic accident with a Glasgow Coma Score (GCS) of 3/15 and fixed pupils. CT brain revealed uncal herniation and diffuse cerebral oedema with associated multiple facial and skull fractures. 72 h later, his clinical condition remained the same with high intracranial pressure refractory to medical management. Clinical confirmation on brain death was not feasible owing to facial injuries. A CTA, performed to determine brain perfusion, yielded a ‘false-negative’ result. Skull fractures have possibly led to venous prominence in the cortical and deep venous drainage system. This point needs to be borne in mind while considering CTA as an ancillary test to confirm brain death.