kids’ korner
1. MRI takes much longer than a CT scan, meaning
the patient must remain still for a much longer
period of time, and may even require sedation for a
younger child
2. No metal (such as orthodontic work) can be
located in the vicinity of the scanner
3. The MRI machinery is large and noisy, and can be
quite troublesome for patients who are uncomfortable in enclosed spaces
4. The MRI may show images which at first glance
may seem abnormal, but in fact have no bearing on
the patient’s condition.
So how do we decide when it is appropriate to order
imaging and how do we decide which scan to use? Most
of my colleagues will agree that CT scans are best used
for acute trauma in an emergency department setting. A
CT scan is appropriate for the patient who has been in
an auto accident or has incurred other significant head
trauma in which bleeding in the areas around the brain
should be ruled out. Because the CT scan can be done
quickly, it is well suited for emergency situations.
MRI scans are the preferred tests if there is a possibility
about a tumor, but relatively few headache patients give
us cause for that concern. When a child or adolescent
presents to the neurologist or headache specialist, our first
responsibility is to determine whether the headache is a
primary headache (one with no definable anatomic cause)
or a secondary headache, in which the pain is caused by
an identifiable cause either in ܈\