Abstract

Brain imaging with computed tomography (CT) is commonly performed in those with suspected intracranial abnormalities. The indications are many, among which trauma is the commonest followed by meningoencephalitis. We present a retrospective review of 663 pediatric CT scans performed in our secondary care center in the United Kingdom for over three years. The aim of the study was to review (a) Indications for CT scan other than trauma, (b) Evaluate the distribution of scan requests during and outside office hours, (c) Correlation of scan findings with ancillary investigations such as lumbar puncture and clinical recordings such as Glasgow coma scale (CGS), and (d) Positive predictive value (PPV) of CT scan with respect to clinical outcomes in diagnosis of meningoencephalitis In this study, they found no direct correlation of CT findings with signs of raised intracranial pressure and there was a poor positive predictive value of CT findings in the diagnosis of meningoencephalitis and raised intracranial pressure. We conclude that in our center, there is a low clinical referral threshold for CT brain imaging in children with suspected meningoencephalitis. The study shows that CT brain scan is valuable in the diagnosis of complications of meningitis but has a poor predictive value for the diagnosis of meningitis/encephalitis and raised intracranial pressure. We recommend that brain imaging with CT should be performed in the appropriate clinical setting and the risk of radiation in children should not be ignored. Magnetic resonance imaging (MRI) may be a more sensitive modality in clinically stable patients when imaging is required

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