| Postpuncture CSF leakage: a potential pitfall of radionuclide cisternography. | |
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MedLine Citation:
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PMID: 21060096 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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OBJECTIVE: We sought to evaluate radioisotope cisternography (RICG)-related postpuncture CSF leakage by MRI. METHODS: We conducted a prospective 3-day imaging study. Ten patients with orthostatic headache and other symptoms underwent pre-RICG brain and spinal MRI, magnetic resonance myelography (MRM), RICG, and post-RICG spinal MRI and MRM. For RICG, we used a 25-gauge pencil point spinal needle at the L3/4 or L4/5 level after which subjects took bed rest for 2.5 hours. RESULTS: On pre-RICG MRI and MRM, none of the 10 patients showed CSF leakage. However, 5 subjects (50%) showed epidural abnormalities suggesting CSF leakage on MRI after lumbar puncture for RICG. On RICG and subsequent MRM, 4 of the subjects showed definite findings of CSF leakage and 1 showed minimal leakage. CONCLUSIONS: RICG carries a risk of iatrogenic CSF leakage even with careful puncturing using a fine needle. This leakage produces abnormal RICG and MRM findings at the lumbosacral level. Therefore, abnormal RICG findings restricted to the lumbosacral level should be carefully interpreted when diagnosing SIH. |
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Authors:
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K Sakurai; M Nishio; S Sasaki; H Ogino; J Tohyama; K Yamada; Y Shibamoto |
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Publication Detail:
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Type: Comparative Study; Journal Article; Research Support, Non-U.S. Gov't |
Journal Detail:
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Title: Neurology Volume: 75 ISSN: 1526-632X ISO Abbreviation: Neurology Publication Date: 2010 Nov |
Date Detail:
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Created Date: 2010-11-09 Completed Date: 2010-12-06 Revised Date: 2011-05-12 |
Medline Journal Info:
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Nlm Unique ID: 0401060 Medline TA: Neurology Country: United States |
Other Details:
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Languages: eng Pagination: 1730-4 Citation Subset: AIM; IM |
Affiliation:
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Department of Radiology, Nagoya City University Graduate School of Medical Sciences, 1 Kawasumi, Mizuho-cho, Mizuho-ku, Nagoya 467-8601, Japan. ksak666@yahoo.co.jp |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Adult Aged Cerebrospinal Fluid Rhinorrhea / etiology, radiography, radionuclide imaging Female Headache / etiology, radiography, radionuclide imaging Humans Intracranial Hypotension / radiography, radionuclide imaging Magnetic Resonance Imaging / methods Male Middle Aged Myelography / adverse effects, methods* Prospective Studies Spinal Puncture / adverse effects* |
| Comments/Corrections | |
Erratum In:
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Neurology. 2011 Mar 22;76(12):1112 |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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