Diagnostic Procedures
For an infant showing signs of a brain injury, prompt diagnosis is critical. If a baby is showing signs of brain trauma, such as a loss of consciousness, dilated pupils, respiratory failure, spinal fluid leakage, irregular pulse and blood pressure, paralysis, or coma, there are several diagnostic procedures that can be performed.
Get A 100% Free CASE EvaluationThe severity of an injury is often obvious by looking at the symptoms. However, the following procedures can reveal the exact magnitude of the problem and help physicians make an accurate diagnosis.
Medical Imaging
Several imaging tests are available that can provide a definitive answer as to whether there has been an injury to the brain. Diagnostics can be run even during pregnancy. An ultrasound can detect issues such as microcephaly, as early as the second trimester. Magnetic resonance imaging, or MRI, can create detailed images of the brain using magnetic fields and radio waves. Although detailed, this test is often not part of acute care because it takes longer than other methods of testing.
Computed tomography (CT) tests, however, take less time and comes with a lower risk of complications. Less sensitive than an MRI, a CT scan provides a full picture by taking X-rays from various angles. It can quickly spot bruised tissue, brain bleeding, and other kinds of damage that might be treatable if found quickly. Other diagnostic imaging tests include a Functional MRI that maps the anatomy and functions of the brain, Diffused Tensor Imaging, Positron Emission Tomography, and Single Photon Emission Computed Tomography.
Physical Exam
A condition such as microcephaly can be suspected if the circumference of the baby’s head is irregular compared to others of the same age and gender. If the condition is present, the measurement values may be two standard deviations or more from the average size. The basic cognitive functions of the infant will be assessed, including motor functions, reflexes, and responses to light/sound/touch to find reason to suspect a brain injury.
Glasgow Coma Scale
The Pediatric Glasgow Coma Scale is designed for assessing consciousness in children less than two years old. It is scored on a scale from 1-15. The lower the number, the more severe the suspected brain injury. A patient who does not respond to commands or opens their eyes may be considered to be in a coma, but the specific responses analyzed include.
- Eye opening response: The scale considers whether the eyes open spontaneously, in response to speech, or with pain, or not at all.
- Verbal response: Coos and babbles are considered normal in an infant and comparable to being oriented and conversational (a full 5 points). Confusion is identified by continual crying and irritability. Lower points are assigned to infants that cry in pain, moan when in pain, or show no response.
- Motor response: Exhibiting spontaneous and purposeful movements, an infants motor response receives 6 points. If the baby withdraws from touch, that’s 5 points. Lower designations are assigned to those who withdraw from pain or exhibit abnormal flexion, or decorticate response, or extension (decerebrate response), when subject to pain.