2018 AANS Annual Scientific Meeting-AANS/CNS Section on Pediatric Neurological Surgery, Question and Answer Session II

Video Transcription

We have time for questions, if there are any. Comments? What do you, are you currently, I'm assuming given your presence at Utah that you're still using the Utah score.  Do you have any particular recommendation for people like myself or elsewhere as to where to start? I think that's reasonable.  I think the McGovern score, just adding on to our score the mechanism of injury improves the misclassification.  I think you have to first start thinking about it in the, you know, in the trauma setting. And so I think that's reasonable. We're prospectively evaluating the Utah score,  but we're reviewing every child who gets a CTA. So we don't want to increase our CTA use, and I think that's one of the risks of broad rule out of a score like this.  But I think at least understanding what the risk factors are and thinking about it is the most important thing at this point for screening. Lisa? Rob, that was really good.  I recently tried to put together some guidelines with our trauma group for this, and there was so much contention between our two groups about it.  It constantly comes up, so it would be really nice to have something. But my question is, and I may have missed you mentioning this,  but our MR angiography seems to have improved so much over the last few years. And our neuroradiologists really feel that they can get a really good assessment  of the arteries with MR. Do you see that? I mean, it'd be so great with kids, right? Do you see that becoming a bigger tool for us in the future? I think it's possible.  I mean, I think CTA is extremely sensitive now. And so I think if we look at, the way I approach it is selective screening of children  at high risk with CTA, where I think it's clearly worth the risk.  I think that broadly rolling out MRA, sort of, if you think about the workflow process and evaluating a trauma patient and the trauma bay and things like that,  they're already going to CT, you know. They're headed there. It's just another scan. So I think if it's something that you can do, great.  I think it just hasn't been well studied, you know. So I mean, I think if you're picking up injuries, then it's certainly a possibility.  But we don't have a lot of information on it, unfortunately. So, okay, thank you.

Video Summary

In this video, the speaker is discussing the use of the Utah score for assessing traumatic injuries in children. They suggest that adding the mechanism of injury can improve the accuracy of the score. They also mention that they are prospectively evaluating the Utah score but are cautious about increasing the use of CTAs (computed tomography angiography). The speaker mentions the use of MR angiography as a potential tool for assessing arterial injuries in children, but states that it has not been well-studied. They emphasize the importance of understanding the risk factors and considering screening in trauma settings. A question is asked about the potential for MR angiography to become a more widely used tool, but the speaker highlights the lack of information on its effectiveness.

Asset Caption

AANS/CNS Section on Pediatric Neurological Surgery, Question and Answer Session II

Keywords

Utah score

traumatic injuries

children

mechanism of injury

MR angiography