Related Experiment Video
Updated: Aug 20, 2026
Making MR Imaging Child's Play - Pediatric Neuroimaging Protocol, Guidelines and Procedure
Published on: July 30, 2009
[Pediatric neuroimaging emergencies]
C Adamsbaum1, Y Rolland, B Husson
1Service de Radiologie, Hôpital St Vincent de Paul, 82 avenue Denfert Rochereau, 75674 Paris Cedex 14, France. svp.radio@svp.ap-hop-paris.fr
Insights
Pediatric neuroimaging emergencies guide CT or MRI use based on clinical signs like head trauma, seizures, or altered consciousness. Urgent imaging is crucial for suspected trauma, intracranial hypertension, or spinal cord symptoms in children.
Area of Science:
- Pediatric Neurology
- Neuroradiology
- Emergency Medicine
Context:
- Establishing clear clinical indications for pediatric neuroimaging in emergency settings is crucial.
- Guidelines differentiate imaging needs based on age, symptoms, and suspected conditions.
- Accurate diagnosis relies on understanding specific presentations of neurological emergencies in children.
Purpose:
- To outline essential clinical indicators for urgent neuroimaging in pediatric emergencies.
- To differentiate between conditions requiring immediate imaging and those that do not.
- To provide a framework for decision-making in pediatric neuroimaging.
Summary:
- Head trauma in children under 2 necessitates CT for specific symptoms like vomiting, seizures, or skull fracture signs.
- Imaging for headaches is reserved for suspected space-occupying lesions; typical febrile seizures do not require imaging.
- Neonatal seizures or loss of consciousness warrant immediate CT or MRI to rule out serious conditions. Spinal cord symptoms demand urgent MRI.
Impact:
- Facilitates timely and appropriate neuroimaging, improving diagnostic accuracy in pediatric emergencies.
- Reduces unnecessary imaging, optimizing resource allocation and minimizing patient exposure.
- Enhances clinical management by providing clear decision-making pathways for pediatric neurological emergencies.
Abstract:
The notion of emergency with regards to pediatric neuroimaging requires a strong knowledge of clinical indications. In children under 2 years of age, head trauma requires a CT scan in case of repeated or prolonged or rapidly increasing vomiting, focal signs, loss of consciousness, unusual behavior, seizures, clinical signs of skull fracture or polytrauma. The "shaken baby syndrome" is usually suspected in case of loss of consciousness or seizures before 8 months of age. The hematomas that are observed are subdural in location, diffuse and deeply located. Imaging is only mandatory for headache suggesting underlying space occupying lesion: permanent or increasing pain, nocturnal headache, headache during postural changes or efforts, associated to seizures or abnormal neurological examination. No imaging is indicated in case of first epileptic seizure associated to normal neurological examination and without any particular context. The presence of trauma, intracranial hypertension, persisting disturbances of consciousness or associated focal sign necessitates urgent neuroimaging. No imaging is indicated in case of typical febrile seizures, i.e. generalized, brief and occurring between 1 and 5 years of age. Spinal cord symptoms require immediate MRI evaluation. The most frequent tumor is neuroblastoma. In the absence of spinal tumor, brain abnormalities must be excluded (inflammatory disease). In neonates, CT scan or MRI must be readily performed in case of seizures or loss of consciousness to exclude ischemic, traumatic or infectious lesions.
