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Cranial computed tomography in the under twos
Insights
Cranial computed tomographic (CT) scans in young children frequently reveal abnormalities, particularly in cases of seizures with neuro-developmental symptoms. Even normal CT scans are valuable for ruling out serious intracranial conditions.
Area of Science:
- Pediatric Radiology
- Neuroradiology
- Child Neurology
Background:
- Cranial computed tomographic (CT) scans are frequently utilized in pediatric patients.
- Understanding the diagnostic yield and findings in infants and toddlers is crucial for effective management.
Purpose of the Study:
- To review the findings and diagnostic utility of cranial CT scans in children aged 0-2 years.
- To identify common indications and abnormalities detected by CT in this age group.
Main Methods:
- Retrospective review of 100 consecutive cranial CT scans performed on children aged 0-2 years.
- Analysis of scan indications, findings, and impact on patient management.
Main Results:
- 73% of CT scans were abnormal, with developmental central nervous system (CNS) malformations and cerebral atrophy being the most common findings.
- Seizures were the most frequent indication, with the highest diagnostic yield when associated with neuro-developmental symptoms.
- Normal CT scans were also valuable in excluding intracranial pathology, aiding management decisions.
Conclusions:
- Cranial CT scans are highly informative in children aged 0-2 years, with a high rate of abnormality detection.
- CT plays a vital role in diagnosing neurological conditions and guiding management, even when scans are normal.
Abstract:
One hundred consecutive cranial computed tomographic scans were reviewed in children aged 0-2 years, presenting to the Royal Belfast Hospital for Sick Children. The mean age at scanning was 8.3 months and 73% of the scans were abnormal. The majority of scans were performed electively (78%). The commonest indication for a scan was seizures (31) and the diagnostic yield was highest where they were associated with other neuro-developmental symptoms. The usefulness of the CT scan was not limited to the abnormal studies but contributed to management in children with normal scans by excluding important intracranial pathology. Developmental CNS malformation (16 scans) and cerebral atrophy (15 scans) were the most frequent CT abnormalities encountered.