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AJNR - American Journal of Neuroradiology

Publication Preview: Published October 8, 2008

American Journal of Neuroradiology 2009;30:516.

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American Journal of Neuroradiology
DOI 10.3174/ajnr.A1294

SPINE

Localization of a Rapid Cerebrospinal Fluid Leak with Digital Subtraction Myelography

J.M. Hoxworth, A.C. Patel, E.P. Bosch and K.D. Nelson

From the Departments of Radiology (J.M.H., A.C.P., K.D.N.) and Neurology (E.P.B.), 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.