False localisation of CSF leak on nuclear medicine myelogram
Low pressure headache suggestive of CSF leak.
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Increased activity is noted on the left at C1/2 level. This should not be interpreted as being the site of leakage, as CSF in the epidural space can ascend and exit the canal at this level. It is known as a false localising sign, also encountered on CT myelography.
This patient had a thoracic calcified disc eventually identified as the cause and was treated successfully with a blood patch.