Cryptogenic Cerebrospinal Fluid Leaks in Spontaneous Intracranial Hypotension: Role of Dynamic CT Myelography

Radiology
Tomas DobrockyEike Piechowiak

Abstract

Purpose To propose a modified dynamic CT myelographic technique to locate cerebrospinal fluid (CSF) leaks, also known as cryptogenic leaks, in patients with spontaneous intracranial hypotension (SIH) in whom previous imaging did not show the dural breach. Materials and Methods This retrospective analysis included 74 consecutive patients with SIH and a myelographically proven CSF leak who were evaluated between February 2013 and October 2017. In 14 patients, dynamic CT myelography in the prone or lateral position showed the exact leakage point after unsuccessful previous imaging. During image analysis, the first time point showing extrathecal contrast material was defined as the site of dural breach point. Results Mean population age was 44 years (range, 25-65 years [nine women; mean age, 44 years; age range, 25-65 years] [five men; mean age, 46 years; age range, 29-61 years]). All patients had previously undergone spine MRI, conventional dynamic myelography, and CT myelography. Subsequent dynamic CT myelography covered a mean range of seven vertebral levels. The leak was caused by a calcified microspur in 10 patients and by a dural tear at the axilla of a spinal nerve root in the remaining four. The mean volume CT dose index of...Continue Reading

References

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Citations

Jun 21, 2019·Magnetic Resonance in Medical Sciences : MRMS : an Official Journal of Japan Society of Magnetic Resonance in Medicine·Genki FukumotoHiroaki Kimura
Feb 15, 2020·Radiographics : a Review Publication of the Radiological Society of North America, Inc·Dhruv M PatelMichael J Hoch
Aug 18, 2020·Clinical Neuroradiology·Patrick J NicholsonRichard I Farb
Oct 8, 2019·Radiographics : a Review Publication of the Radiological Society of North America, Inc·Melike GuryildirimMehmet Kocak
Oct 15, 2020·Deutsches Ärzteblatt International·Horst UrbachJürgen Beck
Jul 1, 2021·AJR. American Journal of Roentgenology·Peter G KranzTimothy J Amrhein
Jul 24, 2021·Neuroradiology·Niklas LuetzenHorst Urbach

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