The surge in computed tomography (CT) imaging in the last two decades has spurred an unintended consequence (apart from increasing patients’ radiation exposure)—an increase in the number of incidental findings, or incidentalomas. These worrisome, unanticipated spots on a scan might indicate malignancy or, as is more often the case, point to a benign finding.
It’s natural for parents to worry: A headache. A seizure. A concussion. What if my child has a brain tumor? Brain scans are on the rise, and pediatricians may be tempted to turn to them as a diagnostic aid. That’s especially concerning for computed tomography (CT) scans, which expose children to ionizing radiation. A 2013 study in Pediatrics, for example, found that CT scans are widely used in children with headache, and that 67 percent of these pediatric brain scans were done outside the emergency department setting.
Sometimes brain scans can be misleading or even detrimental. “Most of the diagnosis of neurologic disease should be done at the bedside, through history and physical exam,” says Alan Cohen, MD, neurosurgeon-in-chief at Boston Children’s Hospital. “Imaging can then be used as a confirmatory measure.” …Read More