Computed tomography scan findings among pediatric patients with unprovoked seizures: A hospital-based study

@#<p style="text-align: justify;"><strong>OBJECTIVE:</strong> To describe the radiologic findings in pediatric patients who underwent cranial CT scan for unprovoked seizures at the Philippine General Hospital (PGH) and determine whether there is any association between the demographic characteristics such as age, age at onset, gender, as well as normal or abnormal neurologic examination findings, and the abnormal CT scan findings.</p><p style="text-align: justify;"><b>METHODS:</b> Official results of all pediatric patients who underwent cranial CT scan for unprovoked seizures from January 1, 2015 to December 31, 2015 in PGH were reviewed. Data were described and statistically analyzed for differences in CT scan findings between different sexes, age groups, ages at onset, and presence or absence of neurologic findings.</p><p style="text-align: justify;"><strong>RESULTS AND CONCLUSION:</strong> Of the 88 cases included, 29 (32.95%) had abnormal CT findings. The most common finding was volume loss. No statistically significant difference was noted for the frequency of abnormal CT findings between categories. There was a trend towards more frequent abnormal CT scan findings among males, and among patients exhibiting abnormal neurologic findings.</p>

Estimation of the Risk of Cancer Associated with Pediatric Cranial Computed Tomography.

Background: The role of Computed Tomography (CT) in the medical diagnosis of diseases has greatly expanded, despite the potential risk of cancer following exposures to ionising radiation (X-Ray) from this modality. This risk is particularly of great concern in children, who are more radiosensitive and have many years to manifest radiation effect than adults. Aims: To estimate risk of cancer induction from Pediatric cranial CT. Materials and Methods: A total of 203 patients, who were referred from various pediatric clinics and wards for cranial CT in a teaching hospital in the South Western Nigeria between the year 2011 and 2013 were considered. All patients were grouped into four age (year) groups: less than 1, 1-5, 5-10 and 10-15. A mathematical method was used to estimate the risk of cancer from the effective dose(ED) calculated from volume computed tomography dose index (CTDIvol), dose length product (DLP) and standard conversion factor. Results: The range of CTDIvol (mGy) received by all patients was 10–250 mGy while majority of the patients received 50–100. The range of DLP (mGy.cm) received by all patients and majority of patients was 500–5000 and 2001–2500 respectively. The range of ED (mSv) received by all patients and majority of the patients was 1–25 and 5–10 respectively. The risk estimated with respect to patients’ age showed that patient in the age group 1–5 years have the highest risk of cancer induction while the risk based on gender showed no significant difference. Conclusion: Over 60% of pediatric patients received more than the recommended values of CTDIvol, DLP and ED from cranial CT. Urgent steps must be taken to ensure compliant with international recommended precautions for dose reduction in pediatric medical imaging.

The Relationship between Facial Fractures and Radiologically-proven Cranial Injuries

PURPOSE: In this study, we retrospectively investigated the medical records of patients with facial fractures and suspected cranial injuries in order to determine if there was any relationship between various facial fracture patterns and cranial injuries. METHODS: Medical records were reviewed to identify patients diagnosed with facial fractures who underwent cranial computed tomography (CT) scans. Records were reviewed for gender, age, injury mechanism, facial fracture pattern, and presence or absence of cranial injuries. Facial fracture patterns were classified as isolated fractures (tripod, zygomatic arch, maxilla, orbit, and mandible), combined fractures, or total fractures. Cranial injuries included skull fractures, traumatic subarachnoid hemorrhages, subdural hemorrhages, epidural hemorrhages, and contusional hemorrhages. All cranial injuries were established by using cranial CT scans, and these kinds of cranial injuries were defined radiologically-proven cranial injuries (RPCIs). We evaluated the relationship between each pattern of facial fractures and the incidence of RPCIs. RESULTS: Of 132 eligible patients with facial fractures who underwent cranial CT scans, a total of 27 (20.5%) patients had RPCIs associated with facial fractures. Falls and slips were the most common causes of the fractures (31.8%), followed by assaults and motor vehicle accidents (MVAs). One hundred one (76.5%) patients had isolated facial fractures, and 31 (23.5%) patients had combined facial fractures. Fractures were found most commonly in the orbital and maxillary bones. Patients with isolated maxillary fractures had a lower incidence of RPCIs than those with total mandibular fractures. RPCIs frequently accompanied combined facial fractures. CONCLUSION: Combined facial fractures had a significant positive correlation with RPCIs. This means that facial fractures caused by stronger or multidirectional external force are likely to be accompanied by cranial injuries.

Analysis of Clinical and Imaging on Senile Brain Stem Infarct / 中国医师杂志

Objective To investigate etiology , clinical characteristics and imaging expression of senile brain stem infarct. Methods The etiology and characteristics of clinic, CT and MRI of 51 cases had been summarized . Results The main causes had hypertension, diabetes mellitus and hyperlipidemia, symptoms complicated, frequently occuring site was brain pontine. Conclusion The main clinical appearances of brain stem infarct are complicated and varies, including typical cranial and cross symptoms, and non-typical early diagnosis, so it is easy to misdiagnose and miss diagnose, MRI had unique advantage in the diagnosis of brain stem infarct .