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AJNR - American Journal of Neuroradiology

Published ahead of print on October 18, 2007
doi: 10.3174/ajnr.A0746

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American Journal of Neuroradiology 29:116-121, January 2008
© 2008 American Society of Neuroradiology

SPINE

Gadolinium-Enhanced MR Cisternography to Evaluate Dural Leaks in Intracranial Hypotension Syndrome

S. Albayram^a, F. Kilic^a, H. Ozer^a, S. Baghaki^b, N. Kocer^a and C. Islak^a

^a Division of Neuroradiology, Department of Radiology, Cerrahpasa Medical School, Istanbul University, Istanbul, Turkey
^b Departments of Plastic, Reconstructive, and Aesthetic Surgery, Cerrahpasa Medical School, Istanbul University, Istanbul, Turkey

Please address correspondence to Sait Albayram, Division of Neuroradiology, Department of Radiology, Istanbul University, Cerrahpasa Medical School, KMP stanbul 34300 Turkey; e-mail: salbayram{at}hotmail.com

Background and PURPOSE: We evaluated the use of MR cisternography after intrathecal administration of gadopentetate dimeglumine to detect the presence and localization of CSF leaks in 19 patients diagnosed with spontaneous intracranial hypotension syndrome according to the criteria of International Headache Society.

MATERIALS AND METHODS: Lumbar puncture with an injection of 0.5 mL of gadopentetate dimeglumine into the subarachnoid space in the lumbar area was performed. MR images of the cervical, thoracic, and lumbar regions in axial, coronal, and sagittal planes with fat-saturated T1-weighted images were acquired.

RESULTS: We observed objective CSF leakage in 17 (89%) of 19 patients. In 14 of these 17 patients, the site of dural tear was demonstrated accurately. In 3 of these 17 patients, the contrast leakage was diffuse, and site of the leak could not be located accurately. No leakage was observed in 2 patients. No complications were detected in any of the patients during the first 24 hours after the procedure or during the 6- to 12-month follow-up.

CONCLUSION: The current results demonstrate the relative safety, accuracy, and feasibility of intrathecal gadolinium-enhanced MR cisternography to evaluate dural leaks.