Document Detail

Comparison of the radioisotope cisternography findings of spontaneous intracranial hypotension and iatrogenic cerebrospinal fluid leakage focusing on chronological changes.
MedLine Citation:
PMID:  22990687     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Radioisotope cisternography (RICG) is useful for detecting cerebrospinal fluid (CSF) leakage in spontaneous intracranial hypotension (SIH) patients. However, RICG can cause iatrogenic CSF leakage (ICSFL) due to a lumbar puncture.
OBJECTIVES: To compare the RICG findings of SIH and ICSFL.
METHODS: The presence of direct findings suggesting CSF leakage and indirect findings including early visualization of the bladder and absence of radioactivity over the brain convexities were evaluated in seven SIH and six ICSFL patients. Radioisotope clearance was assessed semi-quantitatively.
RESULTS: In contrast to the variety of anatomical levels at which direct findings were detected in the SIH patients, the ICSFL patients only displayed direct findings at the lumbosacral level. None of the ICSFL patients displayed direct findings at 1 hour after the tracer injection. Although early visualization of the bladder was depicted in all patients, no activity was visualized over the brain convexities in the SIH patients. In the semi-quantitative analysis, the tracer retention index at 24 hours was lower in the SIH patients than the ICSFL patients.
CONCLUSIONS: The early appearance of direct findings above the lumbosacral level, the absence of radioactivity over the brain convexities and a low tracer retention index are suggestive of SIH.
Keita Sakurai; Minoru Nishio; Kazuo Yamada; Masashi Shimohira; Yoshiyuki Ozawa; Noriyuki Matsukawa; Takuya Oguri; Yoshino Ueki; Junko Tohyama; Takemori Yamawaki; Yuta Shibamoto
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Publication Detail:
Type:  Clinical Trial; Comparative Study; Journal Article     Date:  2012-09-18
Journal Detail:
Title:  Cephalalgia : an international journal of headache     Volume:  32     ISSN:  1468-2982     ISO Abbreviation:  Cephalalgia     Publication Date:  2012 Nov 
Date Detail:
Created Date:  2012-11-12     Completed Date:  2013-04-30     Revised Date:  2014-07-31    
Medline Journal Info:
Nlm Unique ID:  8200710     Medline TA:  Cephalalgia     Country:  England    
Other Details:
Languages:  eng     Pagination:  1131-9     Citation Subset:  IM    
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MeSH Terms
Cerebrospinal Fluid Rhinorrhea / etiology*,  radionuclide imaging*
Diagnosis, Differential
Early Diagnosis
False Positive Reactions
Intracranial Hypertension / radionuclide imaging*
Middle Aged
Myelography / methods*
Spinal Puncture / adverse effects*

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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