Potential value of radionuclide cisternography in diagnosis and management planning of spontaneous intracranial hypotension.
OBJECTIVE
Spontaneous intracranial hypotension (SIH) is caused by spontaneous spinal cerebrospinal fluid (CSF) leaks. However, there is debate regarding clinical indication of radionuclide cisternography (RNC) for identification of the actual site of a CSF leak. We therefore investigated the potential value of RNC in SIH.


METHODS
RNC was performed on 30 patients with SIH. Patients were managed with conservative management only or epidural blood patches (EBPs) according to clinical conditions and RNC findings.


RESULTS
RNC revealed direct signs of spinal CSF leaks in 80% of patients. Of this group, complete resolution of headache was obtained in 12 (71%) of 17 patients who received EBP vs. 1 (14%) of 7 patients treated with conservative management only (p=0.02). Complete headache relief with conservative management only was seen in one (14%) patient with direct signs of spinal CSF leaks compared to five (83%) patients without direct signs (p=0.03).


CONCLUSIONS
RNC is useful for diagnosis and better management planning of SIH.
Hyun
Seung Hyup
SH
Department of Nuclear Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Kangnamgu, Seoul, Republic of Korea. sh99.hyun@samsung.com
Lee
Kyung-Han
KH
Lee
Su Jin
SJ
Cho
Young Seok
YS
Lee
Eun Jeong
EJ
Choi
Joon Young
JY
Kim
Byung-Tae
BT
D000328:Adult; D000368:Aged; D017217:Blood Patch, Epidural / Q000379:methods; D005260:Female; D006261:Headache / Q000628:therapy; D006801:Humans; D019585:Intracranial Hypotension / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D009192:Myelography / Q000379:methods; D011877:Radionuclide Imaging; D015203:Reproducibility of Results; D012189:Retrospective Studies; D012680:Sensitivity and Specificity