Neuroradiologic evaluation of pediatric craniocerebral trauma

Although cranial computed tomography (CT) remains the initial diagnostic test in the evaluation and triage of the pediatric head-injury patient, magnetic resonance imagining (MRI) has become the next step in the diagnostic evaluation of those with focal or diffuse neurologic deficits. MRI is better able to demonstrate the extent and location of both hemorrhagic and nonhemorrhagic injury, thereby providing prognostic information. In nonaccidental head injury, MRI has proved valuable in detecting subtle subacute contusions and even not so subtle chronic subdural hematomas that may be difficult to see on CT or that can mimic enlargement of the subarachnoid space on CT.