Imaging of the pediatric brain is challenging. Knowledge of the normal anatomy and appearance of the developing brain at a given age is critical in identifying abnormalities. Brain malformations had been in the domain of the neuropathologist, but with advanced neuroimaging they can be defined in vivo. Phacomatoses have a similar tendency to produce manifestations in the central nervous system and many other tissues. The inborn errors of metabolism are a heterogeneous group of rare diseases with diverse imaging findings. In addition to anatomical magnetic resonance (MR) imaging, metabolic imaging with MR spectroscopy is established in many brain disorders, such as tumors, leukodystrophies, and metabolic conditions. Even though catheter angiography remains the gold standard, MR and computed tomography angiography provide rapid and noninvasive alternatives to evaluate children with vascular lesions. This article presents the classic imaging findings in pediatric neurology, including the commonly seen malformations, metabolic disorders, and trauma in addition to some rarer diseases.
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