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Spinal cerebrospinal fluid leaks detected by radionuclide cisternography and magnetic resonance imaging in patients suspected of intracranial hypotension.
Ohwaki, Kazuhiro; Yano, Eiji; Shinohara, Takayuki; Watanabe, Takehiro; Ogawa, Akiko; Fujii, Norio; Nakagomi, Tadayoshi.
Affiliation
  • Ohwaki K; Department of Hygiene and Public Health, Teikyo University School of Medicine, Tokyo, Japan. Electronic address: ns-waki@med.teikyo-u.ac.jp.
  • Yano E; Department of Hygiene and Public Health, Teikyo University School of Medicine, Tokyo, Japan.
  • Shinohara T; Department of Neurosurgery, Teikyo University School of Medicine, Tokyo, Japan.
  • Watanabe T; Department of Neurosurgery, Teikyo University School of Medicine, Tokyo, Japan.
  • Ogawa A; Department of Neurosurgery, Teikyo University School of Medicine, Tokyo, Japan.
  • Fujii N; Department of Neurosurgery, Teikyo University School of Medicine, Tokyo, Japan.
  • Nakagomi T; Department of Neurosurgery, Teikyo University School of Medicine, Tokyo, Japan.
Adv Med Sci ; 59(2): 196-9, 2014 Sep.
Article in En | MEDLINE | ID: mdl-25323757
PURPOSE: Although many studies have described various features of neuroimaging tests associated with intracranial hypotension, few have examined their validity and reliability. We evaluated the association between CSF leaks detected by radionuclide cisternography and abnormal MRI findings in the accurate diagnosis of intracranial hypotension. PATIENTS/METHODS: We retrospectively assessed 250 patients who were suspected of intracranial hypotension and underwent subsequent radionuclide cisternography. We obtained 159 sagittal and 153 coronal T2-weighted MRI images and 101 gadolinium-enhanced T1-weighted MRI images. We assessed the CSF leaks in relation to a sagging brain, the maximum subdural space in sagittal and coronal images, and dural enhancement. RESULTS: Overall, 186 (74%) patients showed CSF leaks on radionuclide cisternography. A sagging brain was observed in 21 (13%) of the 159 patients with sagittal MRIs. A sagging brain was not associated with CSF leaks (14% vs. 10%; p=0.49). Compared to patients without CSF leaks, those with CSF leaks tended to have a larger maximum subdural space in both the sagittal (3.7 vs. 4.1mm) and coronal (2.5 vs. 2.8mm) images; however, the differences were not significant (p=0.18 and p=0.53, respectively). Dural enhancement was observed only in one patient, who presented with CSF leaks on radionuclide cisternography. CONCLUSIONS: Our study, which included a relatively large population, did not find any association between the findings of radionuclide cisternography and MRI. Future research should focus on identifying more valid neuroimaging findings to diagnose intracranial hypotension accurately.
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Full text: 1 Collection: 01-internacional Database: MEDLINE Main subject: Intracranial Hypotension / Cerebrospinal Fluid Leak / Headache Type of study: Etiology_studies / Evaluation_studies / Incidence_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Limits: Adolescent / Adult / Aged / Child / Female / Humans / Male / Middle aged Country/Region as subject: Asia Language: En Journal: Adv Med Sci Journal subject: MEDICINA Year: 2014 Document type: Article Country of publication: Países Bajos

Full text: 1 Collection: 01-internacional Database: MEDLINE Main subject: Intracranial Hypotension / Cerebrospinal Fluid Leak / Headache Type of study: Etiology_studies / Evaluation_studies / Incidence_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Limits: Adolescent / Adult / Aged / Child / Female / Humans / Male / Middle aged Country/Region as subject: Asia Language: En Journal: Adv Med Sci Journal subject: MEDICINA Year: 2014 Document type: Article Country of publication: Países Bajos