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Imaging of Pediatric Traumatic and Nontraumatic Brain Emergencies

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Atlas of Emergency Imaging from Head-to-Toe

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Abstract

Neuroimaging plays a central role in the initial diagnosis, follow-up, prognosis, and decision-making for various acute intracranial pathologies in children. Whereas the rarity of several of these conditions in children, poorly understood natural histories, limited representation in the literature, nonspecificity of clinical signs, and heterogeneity of treatment responses make frequent neuroimaging desirable, this has to be counterbalanced against associated risks and costs. Considerations which are usually relatively straightforward and minor in adult patients can lead to substantial morbidity and anxiety in pediatric hospitals, for instance, extravasation of even a small amount of IV contrast agent can result in limb edema and/or compartment syndrome. Imaging examinations in small children often require general anesthesia. Similarly, procedures that entail ionizing radiation, i.e., CT and digital subtraction angiography, necessitate diligent justification with dialogue between the neuroradiologist and the clinical team, with every effort made to ensure that call-back examinations are eliminated. This also implies that alternative imaging be performed when feasible for obtaining similar information, for instance, awake bedside transcranial Doppler or alternative fast sequence MR protocol under adequate clinical indications, to assess ventricular size in infants. In yet other cases, established adult pipelines for neuroimaging are not necessarily suitable in children, such as multiphasic CTA for adult stroke patients for triaging of endovascular therapy. Lastly, the availability of pediatric-trained nurses and technologists in a radiology department is fundamental to minimizing morbidity and obtaining high-quality images and for the care of pediatric patients undergoing interventional procedures.

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Authors and Affiliations

  1. Neuroradiology and Image Guided Therapy, Diagnostic Imaging, The Hospital for Sick Children, and University of Toronto, Toronto, ON, Canada

    Prakash Muthusami, Adam A. Dmytriw & Manohar M. Shroff

Authors
  1. Prakash Muthusami
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  2. Adam A. Dmytriw
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  3. Manohar M. Shroff
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Correspondence to Prakash Muthusami .

Editor information

Editors and Affiliations

  1. Department of Radiology, McMaster University, Hamilton, ON, Canada

    Michael N. Patlas

  2. NYU Langone Hospital - Long Island and the NYU Long Island School of Medicine, Mineola, NY, USA

    Douglas S. Katz

  3. Department of Medical, Surgical and Experimental Sciences, University of Medicine and Surgery, Sassari, Italy

    Mariano Scaglione

Section Editor information

  1. Medical Imaging, University of Ottawa, Ottawa, Canada

    Elka Miller

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Muthusami, P., Dmytriw, A.A., Shroff, M.M. (2022). Imaging of Pediatric Traumatic and Nontraumatic Brain Emergencies. In: Patlas, M.N., Katz, D.S., Scaglione, M. (eds) Atlas of Emergency Imaging from Head-to-Toe. Springer, Cham. https://doi.org/10.1007/978-3-030-92111-8_44

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  • DOI: https://doi.org/10.1007/978-3-030-92111-8_44

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  • Publisher Name: Springer, Cham

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  • Online ISBN: 978-3-030-92111-8

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