Intravenous (IV) contrast is helpful in infectious and postinfectious disorders, demyelinating conditions, and brain tumors, which are the common causes of acute cerebellar ataxia in children [19]. MRI Complete Spine MRI of the spine may be helpful in children with ataxia due to causes such as acute disseminated encephalomyelitis, brain tumors, and demyelinating disease, all of which may show additional abnormalities of the spinal cord [29]. Generally, if there is a high clinical suspicion for a condition that may have spinal cord or paravertebral abnormalities, MRI of the spine can be included when imaging the neuroaxis. Although there is no relevant literature discussing the specific use of contrast in MRI of the spine in acute childhood ataxia, addition of postcontrast imaging may be useful in assessing neoplastic, demyelinating, and inflammatory lesions, which are common causes of acute cerebellar ataxia in children [20]. MR Spectroscopy Head There is no relevant literature to support the use of MR spectroscopy head in the initial evaluation of a child with acute ataxia and no history of recent trauma. MRA Head and Neck MR angiography (MRA) of the head and neck may be a helpful tool in assessing ataxia due to a posterior circulation stroke, hemorrhage, or vascular malformation. However, a posterior circulation stroke is rare in children, and this investigation may need to be decided based on the clinical presentation and concern for acute cerebellar infarct [7]. Stroke or vascular malformations may present with ataxia in 1% to 3% of cases [20,26]. Although there is no relevant literature distinguishing between MRA of head and neck versus MRA of either the head or MRA neck alone in these rare vascular causes of acute childhood ataxia, MRA of the head and neck may be more beneficial than either MRA head or neck alone because the site of vascular abnormality may be in either the head or neck or both locations.
Ataxia Child. Intravenous (IV) contrast is helpful in infectious and postinfectious disorders, demyelinating conditions, and brain tumors, which are the common causes of acute cerebellar ataxia in children [19]. MRI Complete Spine MRI of the spine may be helpful in children with ataxia due to causes such as acute disseminated encephalomyelitis, brain tumors, and demyelinating disease, all of which may show additional abnormalities of the spinal cord [29]. Generally, if there is a high clinical suspicion for a condition that may have spinal cord or paravertebral abnormalities, MRI of the spine can be included when imaging the neuroaxis. Although there is no relevant literature discussing the specific use of contrast in MRI of the spine in acute childhood ataxia, addition of postcontrast imaging may be useful in assessing neoplastic, demyelinating, and inflammatory lesions, which are common causes of acute cerebellar ataxia in children [20]. MR Spectroscopy Head There is no relevant literature to support the use of MR spectroscopy head in the initial evaluation of a child with acute ataxia and no history of recent trauma. MRA Head and Neck MR angiography (MRA) of the head and neck may be a helpful tool in assessing ataxia due to a posterior circulation stroke, hemorrhage, or vascular malformation. However, a posterior circulation stroke is rare in children, and this investigation may need to be decided based on the clinical presentation and concern for acute cerebellar infarct [7]. Stroke or vascular malformations may present with ataxia in 1% to 3% of cases [20,26]. Although there is no relevant literature distinguishing between MRA of head and neck versus MRA of either the head or MRA neck alone in these rare vascular causes of acute childhood ataxia, MRA of the head and neck may be more beneficial than either MRA head or neck alone because the site of vascular abnormality may be in either the head or neck or both locations.