Paediatric MRI and Lumbar Puncture with Autism

You have been scheduled to an MRI list at a paediatric hospital. The first patient on the list is an 8-year-old girl for MRI brain and a lumbar puncture. The girl has autism spectrum disorder. She has a mild speech delay but communicates well. Six months ago she had an episode of venous sinus thrombosis with raised intracranial pressure secondary to mastoiditis. The indication for the MRI and lumbar puncture is worsening headache with intermittent low grade fever (highest temperature 37.8°C) over the past two weeks. She weighs 25 kg. She is admitted to the paediatric ward the day before the procedure and you are asked to perform a preoperative assessment.