Brain death and unusual findings in Brain CT Scan: a case report

Many finding in neuroimaging of brain death can mimic other disorders such as subarachnoid hemorrhage (SAH). Here, we report a case of brain death with a CT scan mimicking SAH. Case Report: Our patient was a 28 year old man who was transferred to Tohid Hospital because of decreased level of consciousness after drug overuse and also cardiopulmonary arrest. Brain CT scan at the stage of brain death showed increased density at the basal arteries of circle of Willis and deep venous structures which was suggestive of SAH and to lesser degree CVT. Lumbar puncture (L.P) revealed no RBC and WBC in CSF, and D-Dimer (a sensitive test for CVT) was less than 0.5mg/dl. Therefore the findings in the brain CT scan of our patient were associated with extensive thrombosis in the basal arteries and deep veins. Brain CT scan of a brain dead patient can mimic subarachnoid hemorrhage and cerebral vein thrombosis. Therefore history, clinical findings and paraclinical measures such as CT scan and LP can be useful for proper diagnosis.