Use of fat-suppressed T2-weighted sagittal images after infusion of excess saline into the subarachnoid space as a new diagnostic modality for cerebrospinal fluid hypovolemia: technical note Response

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Title: Use of fat-suppressed T2-weighted sagittal images after infusion of excess saline into the subarachnoid space as a new diagnostic modality for cerebrospinal fluid hypovolemia: technical note Response
Authors: Marcus, HJ
Hughes-Hallet, A
Kwasnicki, RM
Darzi, A
Yang, G-Z
Nandi, D
Item Type: Journal Article
Abstract: The diagnosis of CSF hypovolemia remains controversial. The primary diagnostic factor relies on confirmation of leakage of the CSF based on reduced spinal fluid pressure. Determining the specific leakage site is the most important issue for effective treatment but remains a difficult task. Although CT myelography, radioisotope cisternography, and MRI are commonly performed in the diagnosis of CSF hypovolemia, these techniques can rarely identify the precise leakage site. Therefore, an epidural blood patch is performed in the lumbar spine in many cases. This study reports a new diagnostic modality that can help to confirm the leakage site. Fat-suppressed T2-weighted sagittal images were compared before and after the infusion of 20 ml of saline into the subarachnoid space of the lumbar region to detect the specific leakage site with high probability. Three patients were successfully treated by the epidural blood patch based on data obtained with the new diagnostic modality. Two patients were treated in the cervical region and 1 in the lumbar region. The use of fat-suppressed T2-weighted sagittal images after saline infusion could be a relevant diagnostic modality compared with images obtained by CT myelography, radioisotope cisternography, and ordinary MRI to achieve accurate diagnosis and effective treatment of patients with CSF hypovolemia.
Issue Date: 1-Feb-2016
Date of Acceptance: 1-Feb-2016
URI: http://hdl.handle.net/10044/1/51863
ISSN: 0022-3085
Publisher: American Association of Neurological Surgeons
Start Page: 586
End Page: 586
Journal / Book Title: Journal of Neurosurgery
Volume: 124
Issue: 2
Copyright Statement: ¬©AANS, 2016
Sponsor/Funder: Wellcome Trust
Funder's Grant Number: 100564/Z/12/Z
Keywords: Science & Technology
Life Sciences & Biomedicine
Clinical Neurology
Surgery
Neurosciences & Neurology
1103 Clinical Sciences
1109 Neurosciences
Neurology & Neurosurgery
Publication Status: Published
Appears in Collections:Faculty of Engineering
Division of Surgery
Computing
Faculty of Medicine



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