The Acute Head on CT in Children

What this deck covers

The Acute Head on CT in Children in twelve illustrated clinical cases with worked explanations – case presentations built around clinical images, radiology, teaching illustrations and real laboratory data, with the reference range beside every value a case quotes. This visual, data-interpretation style of practice suits candidates preparing for MRCPCH AKP in particular, alongside Saudi and Gulf licensing examinations such as the Arab Board, DHA and OMSB. Each case gives you a clinical vignette, four options, the correct answer, and an explanation of why each of the other three is wrong.

The twelve cases, in order

1. Awake, then not awake
2. No history of injury at all
3. The scan looks grey all over
4. The spaces that should be there
5. The child with a shunt and a headache
6. Who actually needs the scan
7. A step you can feel
8. Blood where the fluid should be
9. The scan is normal and he is not right
10. Better, then worse
11. Buying time for the brain
12. What the CT could not show

What this deck teaches

• The shape names the compartment. A biconvex lens is extradural and stops at the sutures. A crescent is subdural and crosses them. Blood tracing the sulci is subarachnoid.
• Look at the cisterns before you look for blood. The basal cisterns close first when the brain swells, and their effacement is the sign most often skipped while the eye hunts for a haematoma.
• Small ventricles are not reassuring. With a lost grey-white boundary and effaced sulci they mean diffuse swelling, and the treatment is preventing secondary injury rather than surgery.
• In a shunted child, compare with their OWN scan. Ventricular size means nothing without the baseline. Larger than last time, with morning headache and vomiting, is a blocked shunt.
• Subdurals of different ages with no history is safeguarding. Same-day child protection referral, skeletal survey, ophthalmology and a senior opinion – not a neurosurgical problem first.
• A focal deficit is the indication that outranks anxiety. CT is radiation to a developing brain. The decision rules exist to spare the many while catching the few, and a trivial fall in a well child is not one of them.

Exam pearls from this deck

• The shape names the compartment. A lens stops at the sutures, a crescent does not.
• An infant with subdurals and no history has a safeguarding diagnosis until proven otherwise.

The twelve worked cases in this deck, with the images and the full explanation of every option, are part of Pediatric Case Review membership. See what is included, or start with the free Pediatric Exam Review Sets.

More from this system: all neurology illustrated case decks · neurology board questions for bank-style drilling · the free Pediatric Exam Review Sets · pediatric reference values.