Computerised axial tomography and acute neurological problems of childhood

Idiopathic intracranial hypertension

Idiopathic intracranial hypertension results from cerebral oedema. The symptoms and signs of the condition are reviewed, especially the risks of visual failure if the condition is prolonged without adequate treatment. The most significant symptom in childhood is headache, and the most important sign is papilloedema. The difficulties of diagnosis are discussed, especially the cerebral oedema that can occur on the withdrawal of steroid therapy, and the increased intracranial pressure that may develop with minimal forms of craniostenosis. The causes of intracranial hypertension are many, and include ear infections, venous sinus thrombosis, the use of certain drugs, and as a complication of acute disseminated encephalomyelitis and Cushing's disease, and impaired renal function. The condition may remit spontaneously, but even so a careful watch must be kept on visual acuity. If treatment is needed various drugs can be tried, and if the response is unsatisfactory repeated lumbar punctures will be indicated. It is rarely necessary to consider surgical intervention such as cerebral decompression.

Computerized tomography in cerebral-palsied children

Of a total of 160 patients with cerebral palsy, 80 were studied by computerized tomography. In the congenital group, abnormal studies were found in two of the 12 patients with diplegia, 16 of 18 with hemiplegia, 14 of the 18 with quadriplegia and five of the seven with atonic diplegia. 18 of 21 patients with acquired disease had abnormal CT scans. Computerized tomography is a useful tool for demonstrating the anatomical lesion responsible for cerebral-palsied patients' clinical findings. It is also useful in making a prognosis of functional outcome, and in defining lesions which are correctable by neurosurgery.

Computed cranial tomography in children

The CT head scan is a valuable new device for the diagnosis of intracranial pathology in children. It is especially useful in detection of cerebral tumors, hydrocephalus, blood-fluid collections, and congenital anomalies. Because of its expense, it cannot be recommended for use in screening of children with seizures, headaches, or nonprogressive focal neurologic signs. Other new ultrasonic and tomographic techniques are being developed, making it advisable to use the radiologist as a clinical consultant in selection of appropriate neuroradiologic procedures in children.