Do 6-8 year old girls with central precocious puberty need routine brain imaging?

BACKGROUND The subject of whether all girls with central precocious puberty (CPP) require brain imaging is controversial. FINDINGS A review of the major papers concerning this topic published since 1994 was conducted looking primarily at the frequency of occult intracranial lesions, particularly brain tumors, in girls with CPP. While CNS abnormalities are frequently noted (8-15 %), the proportion of previously unknown findings requiring intervention in 6-8 year old girls is very small, in the range of 0-2 %. CONCLUSION While MRI should still be done in boys and in girls with onset of puberty younger than age 6 and in boys, ordering an MRI should not be routine in 6-8 year old girls with CPP. Suggestions are made as to how to approach the decision-making process with the parents regarding brain imaging in asymptomatic 6-8 year old girls with CPP.