The choice of central nervous system (CNS) imaging depends in part on the circumstances and the age of the patient:
1. Cerebral ultrasound is most advantageous in the evaluation of neonates and young infants as a quick and relatively reliable method to identify intraventricular and parenchymal hemorrhage, periventricular leukomalacia, major malformations, cerebral edema, and hydrocephalus. It is not as useful in identifying more discrete cerebral migrational defects.
2. Computed tomography (CT) has its best application in evaluating seizures associated with head trauma.
3. Magnetic resonance imaging (MRI) is the preferred imaging technique in evaluating causes of epilepsy including migrational defects, mesial temporal sclerosis, acute parainfectious disseminated encephalomyelitis, stroke, and neoplasm.
4. Magnetic resonance angiography (MRA) is of value in defining vascular abnormalities of stroke and stroke-like events.
5. Transcranial doppler can be helpful in determining impending cerebrovascular occlusive disease of sickle cell anemia.
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