Document Detail

Comparison of Computerized Tomography Myelography and Radioisotope Cisternography to Detect Cerebrospinal Fluid Leakage in Spontaneous Intracranial Hypotension.
MedLine Citation:
PMID:  21857401     Owner:  NLM     Status:  Publisher    
ABSTRACT:: Study Design. A retrospective observational study.Objective. To compare the usefulness of radioisotope cisternography (RIC) and computerized tomography myelography (CTM) for the detection of cerebrospinal fluid leakage in spontaneous intracranial hypotension (SIH).Summary of Background Data. Cerebrospinal fluid leakage sites have been generally identified by RIC in patients with SIH. Although a number of reports have recently indicated the usefulness of CTM, which of RIC or CTM more reliably detects leakage sites has not been decided because the two tests have not been directly compared.Methods. Both RIC and CTM were performed and the findings were compared in 12 patients with SIH strictly meeting the 2nd edition of the International Classification of Headache Disorders diagnostic criteria.Results. On RIC, the detection rate of leakage including indirect signs, an early vesicular RI accumulation and delayed ascent of the RI to the cerebral convexity, was observed in 100%, but that of the direct sign, paraspinal RI accumulation, was in 8 patients (67%). On CTM, the epidural collection of intraspinally administered contrast medium was demonstrated in all patients (100%), and the collection site was located in the cervical and thoracic vertebral regions in most cases. When RIC and CTM findings were collated, paraspinal accumulation in the cervical and thoracic regions on RIC corresponded to the entire or a part of the findings on CTM. In contrast, in 4 of 5 patients with paraspinal accumulation in the lumbosacral region, epidural collection was not noted in this region on CTM.Conclusion. In patients with SIH, epidural collection on CTM may more accurately demonstrate cerebrospinal fluid leakage compared to paraspinal RI accumulation on RIC.
Keiji Hashizume; Keisuke Watanabe; Masahiko Kawaguchi; Toshiaki Taoka; Takayuki Shinkai; Hitoshi Furuya
Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2011-8-18
Journal Detail:
Title:  Spine     Volume:  -     ISSN:  1528-1159     ISO Abbreviation:  -     Publication Date:  2011 Aug 
Date Detail:
Created Date:  2011-8-22     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7610646     Medline TA:  Spine (Phila Pa 1976)     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
*Department of Anesthesiology and Pain Management **Department of Radiology, #Department of Radiation Oncology, Nara Medical University, Kashihara, Nara, Japan.
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