Harmless Brain Abnormalities in Kids Pose Disclosure Dilemmas

MONDAY June 14, 2010 -- Unexpected but benign anomalies are often detected in children who undergo "routine" brain MRIs, and guidelines need to be developed to help pediatricians handle these findings, a new study suggests.

"Doctors need to figure out what, if anything, they want to share with parents about such findings because they seldom require urgent follow-up," senior investigator Dr. John Strouse, a hematologist at Johns Hopkins Children's Center, said in a Hopkins news release.

The most common reasons for MRI testing in children are seizures and headaches, or as a requirement for enrollment in certain medical studies.

Strouse and colleagues looked at 953 children, predominantly black and aged 5 to 14, who underwent brain MRIs before enrolling in a study about sickle cell disease, which they all had. Of those children, 63 (6.6 percent) had a total of 68 abnormal brain findings, none of which were related to their underlying condition. None of those 63 children required emergency treatment and only six children (0.6 percent) required urgent follow-ups.

Because unexpected findings often lead to unnecessary tests and fear, pediatricians need to be prepared to deal with such findings, Strouse said. But many feel at such a loss that they either don't have a discussion with the parents or simply refer the child to a neurologist or neurosurgeon for consultation.

"Helpful as it is, imaging technology can open a Pandora's box, sometimes showing us things we didn't expect to see and are not sure how to interpret," lead investigator Dr. Lori Jordan, a pediatric neurologist, said in the news release.

The study appears online June 14 in the journal Pediatrics.

More information

The American College of Radiology, Radiological Society of North America has more about brain MRIs.

Posted: June 2010


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