1043-3155 Pediatr Neurol Briefs pedneurbriefs Pediatr Neurol Briefs Pediatric Neurology Briefs Pediatr Neurol Briefs 2166-6482 1043-3155 2166-3155 Pediatric Neurology Briefs Publishers Chicago, IL, USA PNB-1-53-b 10.15844/pedneurbriefs-1-7-11 Toxic Disorders Neurology Pediatrics Nervous System Diseases Child Development Brain Diseases Neurosurgery Child Infant Neurotoxic Complications of Contrast CT http://orcid.org/0000-0002-0173-7931 Millichap J. Gordon MD 1 2 * Division of Neurology, Children's Memorial Hospital, Chicago, IL Departments of Pediatrics and Neurology, Northwestern University Feinberg School of Medicine, Chicago, IL Correspondence: Dr. J. Gordon Millichap, E-mail: jgmillichap@northwestern.edu 12 1987 01 08 2016 1 7 53 53 Copyright: © 1987 The Author(s) 1987 This work is licensed under the Creative Commons Attribution 4.0 International License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Neurotoxic complications of contrast computed tomography in children

Four children, ages 4-10 yrs, with brain tumors treated at the Univ of Calgary, Alberta, Canada, developed alterations in consciousness and vital signs after contrast-enhanced cranial computed tomography (CT).

 Cranial Computed Tonography Diatrizoate Meglumine Urgent Neurosurgical Intervention

Four children, ages 4-10 yrs, with brain tumors treated at the Univ of Calgary, Alberta, Canada, developed alterations in consciousness and vital signs after contrast-enhanced cranial computed tomography (CT). Each had increased intracranial pressure but was alert and coherent before the IV injection of diatrizoate meglumine 60%, 2 to 2.5 ml/kg. Two children had generalized seizures and two died immediately after the procedure. The authors caution that CT with contrast should be reserved for children who warrant the additional procedure and when the necessity for urgent neurosurgical intervention is not resolved after the nonenhanced scan. [1]

COMMENT. Reactions to contrast enhanced CT are sufficiently frequent to avoid its use as a routine neurodiagnostic procedure, especially in children with brain tumor and raised intracranial pressure. Neurologists requesting a CT in nonsurgical cases will usually specify a pre-infusion scan only, unless the diagnosis suspected requires enhancement of the lesion. Magnetic resonance imaging is a noninvasive technique that provides images of comparable or superior quality without exposure to contrast effects or ionizing radiation. When available, MRI should be used in preference to contrast-enhanced CT, particularly in children.

 Haslam RH Cochrane DD Amundson GM Johns RD Neurotoxic complications of contrast computed tomography in children J Pediatr 1987 Dec 111 6 Pt 1 837 40 10.1016/S0022-3476(87)80197-X 3681547