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Spontaneous intracranial hypotension

Abstract

Full text: A 49-year old female presented with severe postural headache with no history of trauma. A Computed Tomography (CT) study of the brain demonstrated abnormal meningeal enhancement raising the possibility of leptomeningeal metastases. The patient was then referred to Magnetic Resonance Imaging (MRI) which demonstrated diffuse smooth dural enhancement with ancillary findings characteristic of spontaneous intracranial hypotension. The patient was then referred to Nuclear Medicine to confirm the diagnosis and localise the presumed leak 400MBq of 99mTc DTPA was injected via lumbar puncture into the L3-L4 subarachnoid space Posterior images of the spine were taken with a GE XRT single head gamma camera at 1 and 4 hours post administration of radionuclide. Images demonstrated abnormal early arrival of radionuclide in the kidneys and bladder at 1 hour and abnormal leak of tracer was demonstrate at the level of the first thoracic vertebra on the right side at 4 hours. This confirmed CSF leak at this level. Consequently the patient underwent a blood patch and her symptoms resolved. Spontaneous Intracranial Hypotension is a syndrome often unrecognised presenting with symptoms including severe postural headache neck stiffness nausea vomiting tinnitus and vertigo. The diagnosis is frequently suspected from findings on MRI, but  More>>
Authors:
Cardwell, C; Cox, I; Baldey, A [1] 
  1. St. F.X. Cabrini Hospital, VIC (Australia). Departments of Nuclear Medicine and Magnetic Resonance Imaging
Publication Date:
Jul 01, 2002
Product Type:
Journal Article
Resource Relation:
Journal Name: ANZ Nuclear Medicine; Journal Volume: 33; Journal Issue: suppl.; Conference: 32. Annual Scientific Meeting of the Australian and New Zealand Society of Nuclear Medicine, Cairns, QLD (Australia), 4-8 May 2002; Other Information: PBD: 2002
Subject:
62 RADIOLOGY AND NUCLEAR MEDICINE; BLOOD PRESSURE; BRAIN; CAT SCANNING; DIAGNOSIS; DTPA; HYPOTENSION; NMR IMAGING; RADIONUCLIDE KINETICS; TECHNETIUM 99; UPTAKE
OSTI ID:
20382191
Country of Origin:
Australia
Language:
English
Other Identifying Numbers:
Journal ID: ISSN 1324-1435; ANMEFY; TRN: AU0322436061082
Availability:
Available in abstract form only, full text entered in this record;INIS
Submitting Site:
INIS
Size:
page(s) 5
Announcement Date:
Oct 01, 2003

Citation Formats

Cardwell, C, Cox, I, and Baldey, A. Spontaneous intracranial hypotension. Australia: N. p., 2002. Web.
Cardwell, C, Cox, I, & Baldey, A. Spontaneous intracranial hypotension. Australia.
Cardwell, C, Cox, I, and Baldey, A. 2002. "Spontaneous intracranial hypotension." Australia.
@misc{etde_20382191,
title = {Spontaneous intracranial hypotension}
author = {Cardwell, C, Cox, I, and Baldey, A}
abstractNote = {Full text: A 49-year old female presented with severe postural headache with no history of trauma. A Computed Tomography (CT) study of the brain demonstrated abnormal meningeal enhancement raising the possibility of leptomeningeal metastases. The patient was then referred to Magnetic Resonance Imaging (MRI) which demonstrated diffuse smooth dural enhancement with ancillary findings characteristic of spontaneous intracranial hypotension. The patient was then referred to Nuclear Medicine to confirm the diagnosis and localise the presumed leak 400MBq of 99mTc DTPA was injected via lumbar puncture into the L3-L4 subarachnoid space Posterior images of the spine were taken with a GE XRT single head gamma camera at 1 and 4 hours post administration of radionuclide. Images demonstrated abnormal early arrival of radionuclide in the kidneys and bladder at 1 hour and abnormal leak of tracer was demonstrate at the level of the first thoracic vertebra on the right side at 4 hours. This confirmed CSF leak at this level. Consequently the patient underwent a blood patch and her symptoms resolved. Spontaneous Intracranial Hypotension is a syndrome often unrecognised presenting with symptoms including severe postural headache neck stiffness nausea vomiting tinnitus and vertigo. The diagnosis is frequently suspected from findings on MRI, but Nuclear Medicine CSF imaging provides a readily available and cost effective method for confirming the diagnosis, and for making the diagnosis in patients who are unsuitable for or do not have access to MRI. Copyright (2002) The Australian and New Zealand Society of Nuclear Medicine Inc.}
journal = []
issue = {suppl.}
volume = {33}
journal type = {AC}
place = {Australia}
year = {2002}
month = {Jul}
}