Localization of a Rapid CSF Leak with Digital Subtraction Myelography

• Published in: American journal of neuroradiology : AJNR Vol. 30; no. 3; pp. 516 - 519
• Main Authors: Hoxworth, J.M, Patel, A.C, Bosch, E.P, Nelson, K.D
• Format: Journal Article
• Language: English
• Published: Oak Brook, IL Am Soc Neuroradiology 01.03.2009; American Society of Neuroradiology
• Subjects: Biological and medical sciences; Cerebrospinal Fluid; Dura Mater - pathology; Dura Mater - surgery; Epidural Space; Female; Hearing Loss, Sensorineural - etiology; Human viral diseases; Humans; Infectious diseases; Intracranial Hypotension - etiology; Intracranial Hypotension - pathology; Intracranial Hypotension - surgery; Investigative techniques, diagnostic techniques (general aspects); Magnetic Resonance Imaging; Medical sciences; Middle Aged; Myelography - methods; Nervous system; Preoperative Care; Radiodiagnosis. Nmr imagery. Nmr spectrometry; Spine; Subtraction Technique; Thoracic Vertebrae; Viral diseases; Viral diseases of the lymphoid tissue and the blood. Aids; Nervous system diseases; Subtraction; Radiodiagnosis; Leak; Cerebrospinal fluid; Localization; Myelography
• ISSN: 0195-6108; 1936-959X
• DOI: 10.3174/ajnr.A1294

A 53-year-old woman with superficial siderosis underwent spinal MR imaging, which demonstrated a large cervicothoracic epidural fluid collection compatible with a CSF leak. Conventional and dynamic CT myelography failed to localize the dural tear because of rapid equilibration of myelographic contrast between the thecal sac and the extradural collection. The superior temporal resolution of digital subtraction myelography precisely localized the CSF leak preoperatively and led to the successful surgical correction of the dural tear.