Article Figures & Data
Figures
- Fig 1.
A 58-year-old woman with positional headaches and tinnitus. A, Curved plane reformatted image from a CT myelogram demonstrates numerous spinal meningeal diverticula of varying sizes (arrowheads); no CSF leak was directly visualized. B, Coronal T1 postcontrast image from an MR image obtained before treatment shows diffuse smooth dural enhancement (arrows) and pituitary enlargement, compatible with SIH. C, Coronal T1 postcontrast image obtained following blood patching targeting the diverticula seen in A shows resolution of the imaging findings of SIH. The patient's symptoms completely resolved following treatment.
- Fig 2.
Classification of diverticular morphology. Lesions were categorized as either round (A) or multilobulated (B) on the basis of analysis of axial images from CT myelography.
- Fig 3.
Classification of diverticular size. On the basis of the maximum diameter of the diverticulum on an axial CT myelogram, lesions were trichotomized into 3 groups: 0–3 (A), 4–6 (B), or >6 mm (C).
- Fig 4.
Axial CT myelogram obtained immediately following intrathecal contrast administration in a patient with SIH shows an extrathecal contrast collection. These rapidly filling collections indicate the presence of a high-flow CSF leak.
- Fig 5.
Axial CT myelogram shows filling of the proximal nerve root sheaths bilaterally, findings seen intermittently in both controls and patients with SIH that we classified as “prominent” nerve root sheaths.
- Fig 6.
Incidental spinal diverticula in a control patient. Axial CT myelograms demonstrate multiple thoracic spinal diverticula in a 48-year-old woman. The patient underwent the myelography for postoperative back pain; she had no history of headache or other symptoms suggestive of SIH.
Tables
Control SIH P Value Patients with diverticula present (No.) (%) 8 (44) 13 (68) .141a Diverticula per patient (mean) 2.2 (3.3) 6.3 (8.0) .099b Min/median/max 0/0/10 0/2/23 Patients with prominent nerve sheaths present (No.) (%) 14 (78) 17 (89) .405c Prominent nerve sheaths per patient (mean) 2.6 (3.1) 6.1 (4.2) .004c Min/median/max 0/1.5/13 0/5/15 Control SIH P Valuea Morphology Round (No.) (%) 20 (51) 62 (52) .946 Multilobulated (No.) (%) 19 (49) 57 (48) Size 0–3 mm (No.) (%) 9 (23) 22 (18) .711 4–6 mm (No.) (%) 23 (59) 71 (60) >6 mm (No.) (%) 7 (18) 26 (22) Location Cervical (No.) (%) 2 (5) 4 (3) 0.050 Upper thoracic (No.) (%) 6 (15) 33 (28) Lower thoracic (No.) (%) 29 (75) 65 (55) Lumbar (No.) (%) 2 (5) 17 (14) ↵a P value based on the generalized estimating equations test of the difference between groups in proportions in morphologic categories while accounting for multiple observations per patient.
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