Safety of Consecutive Bilateral Decubitus Digital Subtraction Myelography in Patients with Spontaneous Intracranial Hypotension and Occult CSF Leak

Abstract

BACKGROUND AND PURPOSE: Digital subtraction myelography performed with the patient in the lateral decubitus position has the potential for increased sensitivity over prone-position myelography in the detection of spinal CSF-venous fistulas, a well-established cause of spontaneous intracranial hypotension. We report on the safety of performing routine, consecutive-day right and left lateral decubitus digital subtraction myelography in these patients.

Imaging, Clinical, and Demographic Differences in Patients With Type III Spinal Cerebrospinal Fluid Leak (Cerebrospinal Venous Fistulas) Compared With Patients With Types I and II Spinal Cerebrospinal Fluid Leak

“…[1][2][3] Type III spinal CSF leaks were first described in 2014 and are an increasingly recognized cause of spontaneous intracranial hypotension. [4][5][6][7][8][9][10][11][12][13][14] Because these type III leaks are considered to be slower in nature, they do not necessarily result in epidural fluid collections and can be more difficult to detect compared with types I and II CSF leaks. 15 Much has been previously described in the literature related to use of dynamic myelography, computed tomography myelography (CTM), and digital subtraction myelography to detect types I to III spinal CSF leaks.…”

“…Types I and II leaks are most common, with type III leaks being less common and underrecognized 1–3 . Type III spinal CSF leaks were first described in 2014 and are an increasingly recognized cause of spontaneous intracranial hypotension 4–14 . Because these type III leaks are considered to be slower in nature, they do not necessarily result in epidural fluid collections and can be more difficult to detect compared with types I and II CSF leaks 15 …”