AJDRAJNR - American Journal of Neuroradiology

Published ahead of print on October 8, 2008
doi: 10.3174/ajnr.A1294
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American Journal of Neuroradiology 30:516-519, March 2009
© 2009 American Society of Neuroradiology

Case Report
SPINE

Localization of a Rapid CSF Leak with Digital Subtraction Myelography

J.M. Hoxwortha, A.C. Patela, E.P. Boschb and K.D. Nelsona

a Departments of Radiology, Mayo Clinic, Scottsdale, Ariz
b Neurology, Mayo Clinic, Scottsdale, Ariz

Please address correspondence to Dr. Joseph M. Hoxworth, Mayo Clinic, Neuroradiology Section, Department of Radiology, 13400 E Shea Blvd, Scottsdale, AZ 85259-5404; e-mail: hoxworth.joseph{at}mayo.edu

SUMMARY: A 53-year-old woman with superficial siderosis underwent spinal MR imaging, which demonstrated a large cervicothoracic epidural fluid collection compatible with a CSF leak. Conventional and dynamic CT myelography failed to localize the dural tear because of rapid equilibration of myelographic contrast between the thecal sac and the extradural collection. The superior temporal resolution of digital subtraction myelography precisely localized the CSF leak preoperatively and led to the successful surgical correction of the dural tear.




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