In the algorithm of establishment of cerebral death angiographic evidence of circulatory arrest in all afferent cerebral arteries at the level of the brain base or beneath it is an important diagnostic criterium. With the conventional picture of arrest of the cerebral circulation do not correspond cases with arrest of the circulation merely in the vertebral arteries and residual circulations in the intracranial carotid arteries. They are encountered in fatal structural lesions of the brain stem and cerebellum with ascendent (rostral) transtentorial herniations of the anterior cerebellum and in lethal cases of patients after decompressive craniotomy or craniectomy after severe craniocerebral injuries, extensive hemispheral occlusive infarctions or haemorrhages. Controversial are cases of survival of the medulla oblongata when angiography indicates arrest of the circulation in all afferent cerebral arteries. This can be explained by the existence of a spinal collateral circulation - inversion of the blood flow in the a. spinalis ant. and in the posterior spinal arteries up to the level of the medulla oblongata - implemented via the muscular branches of the external carotid arteries, subclavian and spinal arteries which form in the cervical region an anastomototic arterial network called Bosniak’s plexus. Clinical examination and topical evaluation of lacking function of different portions of the brain stem is at the level of the medulla oblongata more important than angiographic evidence of arrested blood flow in the vertebral arteries. Panangiographic evidence of arrest of contrast substance in all afferent acerebral arteries need not be final evidence of cerebral death.

        Key words: cerebral death - cerebral panangiography - arrest of cerebral circulation - spinal