Newborn head computed tomography: trying to feel comfortable.

Congress:

ECR 2019

Poster Number:

C-3554

Type:

Educational Exhibit

Keywords:

Neuroradiology brain, Paediatric, CT, Diagnostic procedure, Education and training

Authors:

P. Alvayay Quilidran¹, V. Schonstedt Geldres¹, X. P. STECHER GUZMAN²; ¹Santiago, Region Metropolitana/CL, ²Santiago, RM/CL

DOI:

10.26044/ecr2019/C-3554

DOI-Link:

https://dx.doi.org/10.26044/ecr2019/C-3554

Fig. 1: Normal neonatal Head CT.

Fig. 2: Common findings in neonatal head. Overlapping sutures (yellow arrow),hyperdense...

Fig. 3: Axial head CT. Hypodense deep nuclei (yellow arrow), and grey-white matter...

Fig. 4: Diffuse cerebral edema. Axial head CT. Hypodense supratentorial white matter...

Learning objectives

To recognize the normal appearance of a newborn-brain computed tomography (CT). To describe the main tomographic findings in common neonatal brain pathologies (hypoxic-ischemic injury, ischemic stroke and brain hemorrhage).

Background

The World Health Organization defines the newborn or neonate as an infant that is under 28 days old. [1] In this age group ultrasound (US) and magnetic resonance (MRI) are the preferred imaging techniques to study the brain. Computed tomography (CT) is seldom used in a non-emergency setting, because of radiation but also because brain CT scan interpretation is harder in these patients. Having said that, CT scan has unbeatable advantages in the emergency setting because of its availability, short acquisition time and accuracy to...

Findings and procedure details

Characteristics of the normal neonatal head CT[2] Marked hypodensity of the cerebral white matter, because of high water content. In particular, the frontal white matter exhibits less attenuation when compared to the rest of the white matter in a healthy neonatal brain. Since most of the brain lesions appear hypodense on CT, there is going to be a decreased contrast between normal and abnormal tissue when compared with older children and adults. Normal differentiation between cerebral and cerebellarwhite matterandgrey matter. If absent, gray matter edema...

Conclusion

This poster emphasizes the normal appearance of a brain CT scan in anew born, to avoid overdiagnosis of pathology. Emphasis is made on differential diagnosis and recommendations for daily practice.

Personal information

Contact details: Dr. Pablo Alvayay Quilodrán Neuroradiology Section. Department of Radiology, Clínica Alemana de Santiago. Chile. Facultad de Medicina Clínica Alemana-Universidad del Desarrollo, Santiago, Chile. Email: [email protected] Dr. Valeria Schonstedt Geldres Neuroradiology Section. Department of Radiology, Clínica Alemana de Santiago. Chile. Email: [email protected] Dr. Ximena Stecher Guzmán Neuroradiology Section. Department of Radiology, Clínica Alemana de Santiago. Chile. Facultad de Medicina Clínica Alemana-Universidad del Desarrollo, Santiago, Chile. Email: [email protected]

References

WHO recommendations on newborn health: guidelines approved by the WHO Guidelines Review Committee. Geneva: World Health Organization; 2017 (WHO/MCA/17.07). Licence: CC BY-NC-SA 3.0 IGO. Mohan S, Rogan EA, Batty R, Raghavan A, Whitby EH, Hart AR, Connolly DJA. CT of the neonatal head. Clinical Radiology 68 (2013). 1155-1166. Inder TE, Volpe JJ. Stroke in the Newborn. Volpe's Neurology of the Newborn (Sixth Edition). 2018; 564-589. Bruno, Christie J et al. “Haemorrhagic stroke in term and late preterm neonates” Archives of disease in childhood. Fetal and...