MRI myelogram with gadolinium

Case contributed by A.Prof Frank Gaillard

Presentation

​Spontaneous intracranial hypotension, failed blood patch x4, negative CT myelography.

Patient Data

Age: 45 years
Gender: Female
Modality: MRI

No evidence of contrast leak/extravasation, particularly at the T8 level. Several scattered tiny nerve root sheath cysts/diverticula noted.

Modality: MRI

MR thoracic myelogram (with intrathecal gadolinium) has been performed with T1 fat suppressed sequences through the thoracic spine at 1 hours and again at 4.5 hours post injection. There is still no evidence of contrast leak/extravasation.

Case Discussion

Identifying slow CSF leaks can be challenging at it is not uncommon for this to require multiple examinations. Blood patch performed speculatively is a very reasonable approach and often results in successful treatment. 

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Case Information

rID: 43359
Case created: 7th Mar 2016
Last edited: 13th Jun 2016
Inclusion in quiz mode: Excluded

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