title: Cerebrospinal fluid leak demonstrated by three-dimensional computed tomographic myelography in patients with spontaneous intracranial hypotension.
abstract: BACKGROUND
  Precise determination of the spinal level of a cerebrospinal fluid leak is important in the diagnosis and treatment of spontaneous intracranial hypotension. The authors report two cases of SIH in which a cerebrospinal fluid leak was demonstrated by three-dimensional computed tomographic (3D-CT) myelography.
  
  
  METHODS
  By overlaying 3D-CT images of contrast-enhanced CSF and the spine, the point of leakage was clearly depicted in the three-dimensional spinal structure, which assisted targeted epidural blood patch under the guidance of fluoroscopy. Although associated chronic subdural hematoma had to be treated by burr hole drainage, the patients' postural headaches subsided after treatment.
  
  
  CONCLUSIONS
  Clear CSF images in relation to vertebral bones are obtainable with 3D-CT myelography, rendering this modality very useful for the diagnosis and treatment of spontaneous intracranial hypotension.
authors.affiliation: Department of Neurosurgery, Gunma University School of Medicine, Maebashi, Gunma, Japan.
authors.forename: Hiroya
authors.initials: H
authors.lastname: Fujimaki
authors.forename: Nobuhito
authors.initials: N
authors.lastname: Saito
authors.forename: Masahiko
authors.initials: M
authors.lastname: Tosaka
authors.forename: Yukitaka
authors.initials: Y
authors.lastname: Tanaka
authors.forename: Keishi
authors.initials: K
authors.lastname: Horiguchi
authors.forename: Tomio
authors.initials: T
authors.lastname: Sasaki
mesh_terms: D000328:Adult; D017217:Blood Patch, Epidural; D005260:Female; D020200:Hematoma, Subdural, Chronic / Q000000981:diagnostic imaging / Q000601:surgery / Q000628:therapy; D006801:Humans; D007091:Image Processing, Computer-Assisted; D021621:Imaging, Three-Dimensional; D019585:Intracranial Hypotension / Q000000981:diagnostic imaging* / Q000628:therapy; D008297:Male; D008875:Middle Aged; D009192:Myelography; D013353:Subdural Effusion / Q000000981:diagnostic imaging* / Q000628:therapy; D014057:Tomography, X-Ray Computed