Radionuclide Cisternographic Findings in Patients with Intracranial Hypotension

J Korean Neurol Assoc > Volume 14(3); 1996 > Article

Journal of the Korean Neurological Association 1996;14(3): 836-841.

두개내 저압 환자의 방사성 동위 원소 뇌조조영술 소견

정선주, 김종선, 이명종, 류진숙*

울산대학교 의과대학 서울중앙병원 신경과, 핵의학과*

Radionuclide Cisternographic Findings in Patients with Intracranial Hypotension

Sun Ju Chung, M.D., Jong Sung Kim, M.D., Myoung Chong Lee, M.D., Jin Sook Ryu, M.D.*

Department of neurology, University of Ulsan., Asan Medical Center Department of Nuclear Medical, University of Ulsan, Asan Medical Center

Abstract

The syndrome of postural headache associated with low CSF pressure usually occurs after a dural puncture, myelography, or spinal anesthesia. However, it can also develop spontaneously or after minor trauma. Although the clinical and MRI findings of this syndrome are well described, radionuclide cisterno-graphic findings have not yet been clearly characterized. We report four patients presenting with postural headache associated with very low or unmeasurable CSF pressure. Three patients developed after minor trauma, while one developed spontaneously. Brain MRI revealed symmetric pachymeningeal enhancement in all four patients. Radionuclide cisternography demonstrated delayed migration of tracer to the cerebral convexity at 6 and 24 hours in three patients, and early soft tissue uptake suggestive of CSF leakage in one. We suggest that these radionuclide cisternographic findings are supportive evidences for the presence of intracranial hypotension and may provide useful information for appropriate treatment.