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Erciyes University Faculty of Medicine, Department of Neurosurgery, Kayseri, Turkey We investigated the value of transcranial Doppler (TCD) examinations of intracranial arteries as a diagnostic test for the confirmation of brain death. Twenty nine patients with intracranial hypertension who subsequently developed brain death according to clinical criteria were evaluated by TCD ultrasonography during a 16-month period. Typical TCD findings in the arteries of brain-dead patients consisted of either absent or reversed diastolic flow or small early systolic spikes in at least 2 intracranial arteries. This waveform abnormality was found in 26 (89.7 %) of the 29 patients confirmed to be brain dead by clinical criteria, and was absent in 3 (10.3 %). This abnormality does not appear in other patients with coma. All patients with waveform abnormality in TCD examination died. TCD, a practical, noninvasive, early and reliable method for the confirmation of brain death, can be a rapid and convenient alternative to confirmatory tests about vascular circulation. Keywords : Brain death, transcranial Doppler (TCD)