Radionuclide Cisternography in Spontaneous Intracranial Hypotension

Bénamor, Myriam; Tainturier, C.; Graveleau, P; Piérot, Laurent

doi:10.1097/00003072-199803000-00003

Cited by 39 publications

(28 citation statements)

References 9 publications

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“…Multiple simultaneous spinal CSF leaks in patients on their first presentation are well described in the literature. 18,21,27,29,30 There are limitations to our study. The most important one is that we used clinical criteria as the reference standard to evaluate the leakage.…”

Section: Discussionmentioning

confidence: 94%

“…The radiotracer may ascend slowly over the convexities or may quickly disappear from the subarachnoid space and then accumulate in the bladder. 18 If there is no active leakage or if the size of the leakage is smaller than the resolution, no direct evidence of the leak is seen. 19,20 RIC offers a more panoramic view of the entire spine, even though the sensitivity of RIC is not very high.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Detection of CSF Leak in Spinal CSF Leak Syndrome Using MR Myelography: Correlation with Radioisotope Cisternography

Yoo¹,

Kim²,

Choi³

et al. 2008

AJNR Am J Neuroradiol

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Section: Discussionmentioning

confidence: 94%

Section: Discussionmentioning

confidence: 99%

Detection of CSF Leak in Spinal CSF Leak Syndrome Using MR Myelography: Correlation with Radioisotope Cisternography

Yoo¹,

Kim²,

Choi³

et al. 2008

AJNR Am J Neuroradiol

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“…Considerably less frequently, the site of the CSF leak can be identified as a zone of parathecal activity (Fig. 1B) [11,12,46,47]. Of note is that meningeal diverticula, if large enough, may also appear as zones of parathecal activity and sometimes as differentiation of activity related to a meningeal diverticulum from an activity related to an actual CSF leak and extrathecal fluid egress.…”

Section: Radioisotope Cisternographymentioning

confidence: 99%

Spontaneous low cerebrospinal pressure/volume headaches

Mokri

2004

Curr Neurol Neurosci Rep

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The majority, if not all, of the cases of spontaneous intracranial hypotension result from spontaneous cerebrospinal fluid (CSF) leaks. The disorder has a broad clinical and imaging spectrum with substantial variability in clinical and imaging features, in CSF findings, and in response to treatment. Headache is the most common symptom and is typically orthostatic, but with chronicity the orthostatic features may blur into a chronic, lingering headache. Other clinical features include neck pain, nausea, emesis, interscapular pain, diplopia, dizziness, change in hearing, visual blurring, radicular upper extremity symptoms, and a variety of other, but much less common, manifestations. The most common imaging feature is diffuse pachymeningeal gadolinium enhancement. Other manifestations include imaging evidence of sinking of the brain, subdural fluid collections, enlargement of the pituitary, engorgement of venous sinuses, and engorgement of epidural venous plexus. CSF opening pressure is typically low and CSF analysis may be normal or show increased protein concentration and a primarily lymphocytic pleocytosis. No longer can the entity be simply equated with post-spinal puncture headaches. The pathogenetic core and the independent variable is decrease in CSF volume, whereas clinical imaging and CSF findings, including CSF opening pressures, are all variables dependent on the loss of CSF volume. Many patients respond well to treatment, but some present stubborn therapeutic challenges. A subgroup of patients with orthostatic headaches is gradually recognized who have disorders other than CSF leaks.

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“…9,10 It must be mentioned, however, that RNC may identify an "active" leak which is why Valsalva and similar maneuvers are recommended either prior to imaging or during imaging to facilitate the leak for detection and localization. 11,12 The sensitivity of RNC is lower in smaller leaks, where the amount of tracer extravasation may be below the resolution of the imaging system and will, therefore, not be detected. [13][14][15] Our limited case series demonstrates that radionuclide cisternography is a useful diagnostic imaging modality in the determination and localization of a CSF leak.…”

Section: Discussionmentioning

confidence: 99%

Radionuclide Cisternography in Detecting Cerebrospinal Fluid Leak in Spontaneous Intracranial Hypotension

Thomas

Menda²,

Graham³

2009

Clinical Nuclear Medicine

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Spontaneous intracranial hypotension (SIH) is an infrequent clinical entity characterized by cerebrospinal fluid (CSF) hypovolemia due to a CSF leak. The cause of the leak in SIH, however, is largely unknown, though structural meningeal weakness and mechanical stress factors have been postulated. Patients with SIH typically present with postural headaches, and occasionally with other symptomology as well, such as nausea, emesis, neck stiffness, and photophobia. In this case series, we present 4 patients who underwent radionuclide cisternography (RNC) for suspected CSF leak. All patients underwent RNC and MR and/or CT for evaluation. We found that RNC accurately detected and localized a CSF abnormality in all 4 patients, with each patient experiencing symptomatic relief following directed epidural blood patch.

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Radionuclide Cisternography in Spontaneous Intracranial Hypotension

Cited by 39 publications

References 9 publications

Detection of CSF Leak in Spinal CSF Leak Syndrome Using MR Myelography: Correlation with Radioisotope Cisternography

Detection of CSF Leak in Spinal CSF Leak Syndrome Using MR Myelography: Correlation with Radioisotope Cisternography

Spontaneous low cerebrospinal pressure/volume headaches

Radionuclide Cisternography in Detecting Cerebrospinal Fluid Leak in Spontaneous Intracranial Hypotension

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