Role of Imaging in pseudotumor cerebri syndrome. / Papel de la radiología en el síndrome de pseudotumor cerebral.

Pseudotumor cerebri is a disorder characterized by increased intracranial pressure that predominantly affects obese young women. This paper aims to define the concepts of primary pseudotumor cerebri, in which the cause cannot be identified (also known as idiopathic intracranial hypertension), and secondary pseudotumor cerebri, in which the cause can be identified. We review the current role of imaging techniques in diagnosing pseudotumor cerebri and describe and illustrate the most characteristic imaging findings of the disorder, some of which are included in the diagnostic criteria proposed in 2013. We also consider the fundamental role of interventional radiology in the treatment of pseudotumor cerebri because placing a stent in stenosed venous sinuses is a novel treatment option in patients who are refractory to classical treatment. Finally, we describe the imaging biomarkers that have been evaluated for diagnosing primary pseudotumor cerebri and predicting the response to treatment.

Linear skull fracture in infants after mild traumatic brain injury: influence of computed tomography in management. / Fractura lineal de cráneo en el lactante con traumatismo craneoencefálico leve: influencia de la tomografía computarizada en su manejo.

INTRODUCTION: Traumatic brain injury (TBI) is a common reason for pediatric emergency room visits. Surgical intervention for mild TBI is rarely necessary in children aged <2 years, but the intracranial findings can influence the management of the patient. This paper aims to evaluate the impact of computed tomography (CT) in the management of children aged <2 years with mild TBI and linear skull fractures on plain-film X-rays. MATERIAL AND METHODS: This retrospective descriptive study analyzed skull X-rays obtained in children <2 years old attended for mild TBI in the emergency room of our tertiary hospital over a 4-year period. RESULTS: A total of 88 CT studies were done for suspicion of linear skull fractures on plain-film X-rays. Fractures were confirmed in 74, representing a false-positive rate of 16%. Of the 74 infants with confirmed fractures, intracranial CT findings were normal in 68 (92%) and abnormal in 6 (8%). Two patients (2.7% of all patients with confirmed fractures) required hospital stays longer than 2 days; the other four patients with abnormal intracranial findings were discharged within 48hours of admission. None of the cases required surgery. CONCLUSION: Systematic CT studies do not seem justified for all children aged <2 years with TBI and low/intermediate risk of intracranial lesions, even when they have linear skull fractures. In the absence of risk factors, we propose individualizing the imaging study based on clinical criteria.