Imaging review of cerebrospinal fluid leaks

Author:

Vemuri Naga V1,Karanam Lakshmi S P1,Manchikanti Venkatesh1,Dandamudi Srinivas1,Puvvada Sampath K2,Vemuri Vineet K1

Affiliation:

1. Department of Radiology, Global Multispecialty Hospital, Vijayawada, Andhra Pradesh, India

2. Department of ENT, Government General Hospital, Guntur, Andhra Pradesh, India

Abstract

AbstractCerebrospinal fluid (CSF) leak occurs due to a defect in the dura and skull base. Trauma remains the most common cause of CSF leak; however, a significant number of cases are iatrogenic, and result from a complication of functional endoscopic sinus surgery (FESS). Early diagnosis of CSF leak is of paramount importance to prevent life-threatening complications such as brain abscess and meningitis. Imaging plays a crucial role in the detection and characterization of CSF leaks. Three-dimensional, isotropic, high resolution computed tomography (HRCT) accurately detects the site and size of the bony defect. CT cisternography, though invasive, helps accurately identify the site of CSF leak, especially in the presence of multiple bony defects. Magnetic resonance imaging (MRI) accurately detects CSF leaks and associated complications such as the encephaloceles and meningoceles. In this review, we emphasize the importance and usefulness of 3D T2 DRIVE MR cisternography in localizing CSF leaks. This sequence has the advantages of effective bone and fat suppression, decreased artefacts, faster acquisition times, three-dimensional capability, y and high spatial resolution in addition to providing very bright signal from the CSF.

Publisher

Georg Thieme Verlag KG

Subject

Radiology, Nuclear Medicine and imaging

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