Document Detail


Postpuncture CSF leakage: a potential pitfall of radionuclide cisternography.
MedLine Citation:
PMID:  21060096     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
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.
Authors:
K Sakurai; M Nishio; S Sasaki; H Ogino; J Tohyama; K Yamada; Y Shibamoto
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Publication Detail:
Type:  Comparative Study; Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Neurology     Volume:  75     ISSN:  1526-632X     ISO Abbreviation:  Neurology     Publication Date:  2010 Nov 
Date Detail:
Created Date:  2010-11-09     Completed Date:  2010-12-06     Revised Date:  2011-05-12    
Medline Journal Info:
Nlm Unique ID:  0401060     Medline TA:  Neurology     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1730-4     Citation Subset:  AIM; IM    
Affiliation:
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
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MeSH Terms
Descriptor/Qualifier:
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:
Neurology. 2011 Mar 22;76(12):1112

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


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