Spinal CSF leak - post-operative (radionuclide cisternography)

Case contributed by Shamus Moran
Diagnosis certain


Pathologic fracture and incomplete spinal cord injury for which he underwent T3-T10 PSIF and laminectomies for decompression. Post-operative course complicated by persistent right pleural effusion positive for beta-2 transferrin, indicating the presence of CSF.

Patient Data

Age: 55
Gender: Male

To the left of the spine at approximately L4-L5, at the site of the prior lumbar drain, there is a CSF leak with a gradual increase in radiotracer accumulation over 48h. 

No radiotracer accumulation is present in the pleural space. 

Case Discussion

CSF leaks can occur at any location along the brain and spinal subarachnoid spaces. Radionuclide cisternography is a mainstay of CSF leak detection, especially when occult on other imaging (CT, MR) yet suspected clinically. 

How to use cases

You can use Radiopaedia cases in a variety of ways to help you learn and teach.

Creating your own cases is easy.

Updating… Please wait.

 Unable to process the form. Check for errors and try again.

 Thank you for updating your details.