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Pediatric Rounds Review Questions
Dizziness and Faintness in an 8-Year-Old Girl

Answer 2

  1. A 12-year-old boy with a dull, throbbing headache that he says gets better when he goes into a quiet room. A dull throbbing headache does not require an emergent head computed tomographic (CT) scan. It is not the characteristic headache of an intracerebral hemorrhage. Unless the patient has other neurologic findings or a past history of syncopal episodes, an emergent head CT scan would not be warranted for the patient described in option C. Option B indicates pathology involving the abducens nerve, which is frequently the first cranial nerve to be affected by inflammatory conditions. An emergent head CT may be necessary in the patient described in option B to rule out compressive changes, but a magnetic resonance image would be more appropriate for showing areas of demyelination. Options A, D and E all suggest an increased cranial pressure or intracranial bleeding causing changes in the mental status of the patients.

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