Sequences such as susceptibility-weighted imaging and diffusion-weighted imaging are helpful in identifying patients with diffuse axonal injury [27], that is typically not apparent on CT examinations. At an interval after trauma, MRI can be useful in the evaluation of post-traumatic epilepsy, allowing for better identification and delineation of the sequela of prior traumatic brain injury, including gliosis, and volume loss. CT Head If imaging is pursued, CT may be useful in the acute post-traumatic settings especially to identify acute intracranial hemorrhage or mass effect. In a study by Lee and Lui [25], CT identified 100% of the acutely treatable lesions in patients with mild trauma. In this study, although CT results were negative in 53% of patients, 7% of patients had lesions that required urgent surgical intervention. FDG-PET/CT Brain There is no relevant literature to support the use of FDG-PET/CT in the acute workup of a child with post-traumatic seizures. HMPAO SPECT or SPECT/CT Brain There is no relevant literature to support the use of Tc-99m HMPAO SPECT or SPECT/CT in the acute workup of a child with post-traumatic seizures. Variant 5: Children 1 month to 17 years of age. Focal seizures, not including abusive head trauma. Initial imaging. Focal seizures are defined as those with onset, limited to one hemisphere of the brain, and include focal aware seizures (retained awareness) and focal impaired awareness seizures (formerly known as complex partial seizures) [3]. Positive yields from neuroimaging of patients with focal seizures are considerably higher when compared with those from imaging of patients with generalized seizures whose neurologic examination is normal [30,31]. Presence of any focal feature to the seizure was found to be independently associated with clinically relevant abnormalities on neuroimaging [32]. Young et al [33] noted a 50% positivity rate for CT when neurologic findings were focal as compared with 6% positive CT findings in patients without focal features.
Seizures Child. Sequences such as susceptibility-weighted imaging and diffusion-weighted imaging are helpful in identifying patients with diffuse axonal injury [27], that is typically not apparent on CT examinations. At an interval after trauma, MRI can be useful in the evaluation of post-traumatic epilepsy, allowing for better identification and delineation of the sequela of prior traumatic brain injury, including gliosis, and volume loss. CT Head If imaging is pursued, CT may be useful in the acute post-traumatic settings especially to identify acute intracranial hemorrhage or mass effect. In a study by Lee and Lui [25], CT identified 100% of the acutely treatable lesions in patients with mild trauma. In this study, although CT results were negative in 53% of patients, 7% of patients had lesions that required urgent surgical intervention. FDG-PET/CT Brain There is no relevant literature to support the use of FDG-PET/CT in the acute workup of a child with post-traumatic seizures. HMPAO SPECT or SPECT/CT Brain There is no relevant literature to support the use of Tc-99m HMPAO SPECT or SPECT/CT in the acute workup of a child with post-traumatic seizures. Variant 5: Children 1 month to 17 years of age. Focal seizures, not including abusive head trauma. Initial imaging. Focal seizures are defined as those with onset, limited to one hemisphere of the brain, and include focal aware seizures (retained awareness) and focal impaired awareness seizures (formerly known as complex partial seizures) [3]. Positive yields from neuroimaging of patients with focal seizures are considerably higher when compared with those from imaging of patients with generalized seizures whose neurologic examination is normal [30,31]. Presence of any focal feature to the seizure was found to be independently associated with clinically relevant abnormalities on neuroimaging [32]. Young et al [33] noted a 50% positivity rate for CT when neurologic findings were focal as compared with 6% positive CT findings in patients without focal features.