![]() ![]() 1b, c), but failed to detect exact leakage site. Axial T2 weighted images of conventional MR showed left paravertebral fluid collection ( Fig. Spinal MR imaging showed a hyperintense T2 signal at the discectomy site, suggesting postoperative changes ( Fig. Here, we describe two patients with surgery-related CSF leakage in whom the leakage sites were accurately detected on MR myelography.Ī 28-year-old woman developed severe headache accompanied by nausea and vomiting one day after a lumbar discectomy at L4-5 level for an intervertebral disc herniation. Among the diagnostic modalities used to determine the site of CSF leakage are magnetic resonance (MR) imaging, computed tomographic (CT) cisternography, and radioisotope cisternography. To provide appropriate treatment, it is essential to detect the exact site of CSF leakage. The usual treatment of CSF leakage consists of drainage of the CSF through a subarachnoid catheter ( 3) and surgical repair of the dural tear ( 4), although an epidural blood patch may also be used ( 5). The patient is likely to experience symptoms of CSF hypovolemia, including postural headache plus nausea, vomiting, pain or tightness in the neck or back, dizziness, diplopia, photophobia, tinnitus, and/or blurred vision. An incidental dural tear resulting in cerebrospinal fluid (CSF) leakage is a complication of spinal surgery, with a reported incidence of between 0.3% and 16% ( 1, 2). ![]()
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