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Clinical practices to be avoided in pediatric neurology: AAP

Written By : Dr Satabdi Saha |Medically Reviewed By : Dr. Kamal Kant Kohli Published On 2021-03-28T20:25:43+05:30  |  Updated On 16 Jun 2023 3:37 PM IST
Clinical practices to be avoided in pediatric neurology: AAP
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The American Academy of Pediatrics has issued a list of five practices to avoid in pediatric neurologic surgery as part of the American Board of Internal Medicine's Choosing Wisely campaign.

The pediatric neurosurgery Choosing Wisely topics were chosen after discussion among the Section on Neurological Surgery (SONS) Executive Committee members regarding the most common pediatric neurosurgery issues and treatments general pediatricians see in their practices. Various expert committees and sections of the AAP reviewed and approved the list. The AAP Executive Committee then granted final approval of the list.

Among them, the key highlights are-

  • Do not routinely perform imaging to evaluate infant head shape, as it unnecessarily exposes the child to radiation. Additionally, positional plagiocephaly and most craniosynostosis cases can be detected via clinical examination. "Most craniosynostosis presentations can also be discerned on clinical examination. Imaging may be obtained by specialists to make the diagnosis in complex cases and, if necessary, for surgical planning." The team opined.
  • Do not routinely perform imaging or elective procedures that call for sedation in very young children with low-risk asymptomatic lesions (for example, small rubbery scalp masses that represent dermoid cysts).

Small rubbery scalp masses representing dermoid cysts or shallow midline sacral dimples do not routinely require intervention as a young infant. Routine magnetic resonance imaging requiring anesthesia is typically not recommended. Given the US Food and Drug Administration's Drug Safety Communication on pediatric anesthesia warning that general anesthesia and sedation drugs used in children younger than 3 years for anesthesia of more than 3 hours or repeated use of anesthetics may affect the development of children's brains, risks and benefits of elective imaging or procedures should be carefully weighed.

  • Do not routinely order computed tomography or magnetic resonance imaging for developmentally normal infants with macrocephaly that's clinically asymptomatic. When imaging is indicated, head ultrasonography should typically be considered as the first-line test for infants with an open fontanelle.

For the full article follow the link: AAP's Choosing Wisely list (Free)

Background: Physician's First Watch coverage of Choosing Wisely list of practices to avoid in pediatric cardiology (Free)

Primary source: American Academy of Pediatrics


pediatricsAmerican Academy of PediatricsPediatric neurology
Source : American Academy of Pediatrics
Dr Satabdi Saha
Dr Satabdi Saha

    Dr Satabdi Saha (BDS, MDS) is a practicing pediatric dentist with a keen interest in new medical researches and updates. She has completed her BDS from North Bengal Dental College ,Darjeeling. Then she went on to secure an ALL INDIA NEET PG rank and completed her MDS from the first dental college in the country – Dr R. Ahmed Dental College and Hospital. She is currently attached to The Marwari Relief Society Hospital as a consultant along with private practice of 2 years. She has published scientific papers in national and international journals. Her strong passion of sharing knowledge with the medical fraternity has motivated her to be a part of Medical Dialogues.

    Dr. Kamal Kant Kohli
    Dr. Kamal Kant Kohli

    Dr Kamal Kant Kohli-MBBS, DTCD- a chest specialist with more than 30 years of practice and a flair for writing clinical articles, Dr Kamal Kant Kohli joined Medical Dialogues as a Chief Editor of Medical News. Besides writing articles, as an editor, he proofreads and verifies all the medical content published on Medical Dialogues including those coming from journals, studies,medical conferences,guidelines etc. Email: drkohli@medicaldialogues.in. Contact no. 011-43720751

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