Postural headache and cerebrospinal fluid leak: believing is seeing.
A 33-year-old woman developed persistent postural headache following epidural anesthesia (L2-L3 level). Iohexol myelography (L5-S1 puncture) demonstrated no epidural extravasation of contrast material (Figure A), but subsequent computed tomography (CT) axial images (B, C) revealed leakage of dye through the needle track of the L5-S1 puncture (arrows). No leakage of contrast medium was found at the site of the L2-L3 epidural puncture.
Goadsby
Peter
P
Institute of Neurology, University College London, London, UK.
Jager
H Rolf
HR
D000328:Adult; D000767:Anesthesia, Epidural / Q000295:instrumentation; D002555:Cerebrospinal Fluid / Q000502:physiology*; D005119:Extravasation of Diagnostic and Therapeutic Materials / Q000000981:diagnostic imaging; D005260:Female; D006261:Headache / Q000209:etiology*; D006801:Humans; D009192:Myelography; D009339:Needles / Q000009:adverse effects; D011187:Posture; D011677:Punctures / Q000009:adverse effects; D014057:Tomography, X-Ray Computed