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Research ArticleSpine

Spinal CSF-Venous Fistulas in Morbidly and Super Obese Patients with Spontaneous Intracranial Hypotension

W.I. Schievink, M. Maya, R.S. Prasad, V.S. Wadhwa, R.B. Cruz and F.G. Moser
American Journal of Neuroradiology February 2021, 42 (2) 397-401; DOI: https://doi.org/10.3174/ajnr.A6895
W.I. Schievink
aFrom the Departments of Neurosurgery (W.I.S., R.B.C.)
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M. Maya
bImaging (M.M., R.S.P., V.S.W., F.G.M.), Cedars-Sinai Medical Center, Los Angeles, California
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R.S. Prasad
bImaging (M.M., R.S.P., V.S.W., F.G.M.), Cedars-Sinai Medical Center, Los Angeles, California
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V.S. Wadhwa
bImaging (M.M., R.S.P., V.S.W., F.G.M.), Cedars-Sinai Medical Center, Los Angeles, California
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R.B. Cruz
aFrom the Departments of Neurosurgery (W.I.S., R.B.C.)
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F.G. Moser
bImaging (M.M., R.S.P., V.S.W., F.G.M.), Cedars-Sinai Medical Center, Los Angeles, California
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    FIG 1.

    A, Anterior-posterior DSM demonstrates a CSF-venous fistula (BMI = 46.9 kg/m2, weight 149 kg, height = 178 cm). B, Lateral DSM demonstrates a CSF-venous fistula (BMI = 40.6 kg/m2, weight = 94.5 kg, height = 152 cm). C, Anterior-posterior DSM demonstrates a CSF-venous fistula (BMI = 40.2 kg/m2, weight = 113 kg, height = 167 cm). D, Anterior-posterior DSM demonstrates a CSF-venous fistula (BMI = 53.7 kg/m2, weight = 151 kg, height = 167 cm). E, Anterior-posterior DSM demonstrates a CSF-venous fistula (BMI = 41 kg/m2, weight = 137 kg, height = 183 cm). F, Anterior-posterior DSM demonstrates a CSF-venous fistula (BMI = 45.4 kg/m2, weight = 161 kg, height = 188 cm). In 2 other patients (BMI = 56.3 kg/m2, weight = 149 kg, height = 163 cm and BMI = 41.8 kg/m2, weight = 140 kg, height = 182 cm, respectively), DSM failed to demonstrate a CSF-venous fistula. Arrows indicates CSF-venous fistulas.

  • FIG 2.
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    FIG 2.

    Sagittal T2-weighted MRIs showing brain sagging and T2 signal change within the cervical spinal cord (presyrinx) (A) and resolution of the presyrinx after surgical ligation of the thoracic CSF-venous fistula due to resolution of brain sagging and cerebellar tonsillar herniation (B).

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American Journal of Neuroradiology: 42 (2)
American Journal of Neuroradiology
Vol. 42, Issue 2
1 Feb 2021
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W.I. Schievink, M. Maya, R.S. Prasad, V.S. Wadhwa, R.B. Cruz, F.G. Moser
Spinal CSF-Venous Fistulas in Morbidly and Super Obese Patients with Spontaneous Intracranial Hypotension
American Journal of Neuroradiology Feb 2021, 42 (2) 397-401; DOI: 10.3174/ajnr.A6895

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Spinal CSF-Venous Fistulas in Morbidly and Super Obese Patients with Spontaneous Intracranial Hypotension
W.I. Schievink, M. Maya, R.S. Prasad, V.S. Wadhwa, R.B. Cruz, F.G. Moser
American Journal of Neuroradiology Feb 2021, 42 (2) 397-401; DOI: 10.3174/ajnr.A6895
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