HG197 CHLORMERODRIN FOR BRAIN SCANS IN CHILDREN

Abstract

A small series of 86 children studied by Hg¹⁹⁷ brain scans is presented. Because of the high frequency of neoplasms in the posterior fossa in childhood, the efficacy of scans of this area is of particular interest. The experience in this area cited in the literature,^5,10,16,17 as far as we have determined, seems limited to a few cases. Where neoplasms have occasionally been reported in the posterior fossa previously, Hg²⁰³ or ¹³¹ had often been used.¹⁷ The ability to demonstrate abnormal findings on scans in such common pediatric posterior fossa neoplasms as medulloblastoma, cerebellar astrocytoma and pontine glioma with the lower energy isotope, Hg¹⁹⁷, as reported here in our preliminary observations, is encouraging. The small experience reported here with supratentorial astrocytoma would appear to agree with that of others previously reported; the more malignant grades of this glioma are better demonstrated.^10,13,16 Our experience would also confirm the claims of others^12,13 that subdural hematomas should show a high incidence of positive scans. The ability to demonstrate a benign cyst (Patient M.R.) was unexpected. One may postulate that the isotope either concentrated in the wall of the cyst or in the compressed cerebral tissue around the cyst. We believe that brain scanning is a useful survey study which is adaptable for the pediatric age group under the conditions noted. It should be part of a series of diagnostic studies which include skull survey roentgenography, electro and sonar encephalography (which we have not attempted to correlate in this report), and the more detailed roentgenographic procedures of arteriography and/or air study [See Figure in the PDF file] as indicated by the circumstances. In some cases, as in Patients A.M. and S.G., the brain scan may well assume prime importance. In certain instances, when a diagnosis of metastatic disease is entertained, and no surgery is planned, it may make a more involved roentgenographic procedure unnecessary (Patient R.P.).