shirini2
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Which one of the following is a useful technique for localizing the site of a cerebrospinal fluid (CSF) leak after performing a lumbar puncture?
1) CT scanning
2) radionuclide scanning
3) MR scanning
4) pneumoencephalography
5) electroencephalography (EEG)
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| anastamosis
Forum Senior
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b
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| shirini2
Forum Senior
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how about 1 ?
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| anastamosis
Forum Senior
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there are two views about your question
1. The leak is occuring after LP
2. The technique is to be used after LP
which one do you think is correct? i say 2. coz if the leak is occuring after LP, you know where it is leaking!
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| hero
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after exploring knowledgeable resources looks like 1, 2 and 3 could be correct
but CT is the first choice
http://www.emedicine.com/RADIO/topic139.htm
http://www.utmb.edu/otoref/Grnds/CS-Leak-021002/C...
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| anastamosis
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i still go with B
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| hero
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here is abt MRI as the best
Magnetic resonance imaging has revolutionized the diagnosis of ICH. The major abnormalities demonstrated on MR imaging studies in patients with ICH are diffuse
thickening of the pachymeninges with Gd enhancement,
engorgement of venous sinuses, subdural fluid collections, enlargement of the pituitary gland, and downwarddisplacement of the brain.
The resolution of these abnormalities on MR images parallels improvement in clinical symptoms.
http://www.aans.org/education/journal/neurosurgic...
and here is from 2000 article that
Radionuclide cisternography is an ideal imaging method for detecting and localizing a CSF leak, particularly when complemented by directed, thin-section CT.
http://gamma.wustl.edu/cl003te114.html
if it is matter of time and nowadays there is another data..
in this country it should be guidelines, can't find
Edited by hero on 01/07/08 - 08:55 PM
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| neurom
Forum Senior
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CT scan. CT cysternography is even better in the absence of an obvious skull defect.
Radioisotope skan was good prior to the development CT and MRI.
MRI lacks accuracy (in localizing CSF leak) because it does not show a fine bone detail along the skull base.
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| multifactorial
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i would think radionuclide studies.
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