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CC BY-NC-ND 4.0 · Indian J Radiol Imaging 2017; 27(04): 441-446
DOI: 10.4103/ijri.IJRI_380_16
Neuro/Head & Neck

Imaging review of cerebrospinal fluid leaks

Naga V Vemuri
Department of Radiology, Global Multispecialty Hospital, Vijayawada, Andhra Pradesh, India
,
Lakshmi S P Karanam
Department of Radiology, Global Multispecialty Hospital, Vijayawada, Andhra Pradesh, India
,
Venkatesh Manchikanti
Department of Radiology, Global Multispecialty Hospital, Vijayawada, Andhra Pradesh, India
,
Srinivas Dandamudi
Department of Radiology, Global Multispecialty Hospital, Vijayawada, Andhra Pradesh, India
,
Sampath K Puvvada
Department of ENT, Government General Hospital, Guntur, Andhra Pradesh, India
,
Vineet K Vemuri
Department of Radiology, Global Multispecialty Hospital, Vijayawada, Andhra Pradesh, India
› Author Affiliations Financial support and sponsorship Nil.
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Abstract

Cerebrospinal 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.

Keywords

Cerebrospinal fluid leaks - Cisternography - T2 Drivel


Publication History

Article published online:
27 July 2021

© 2017. Indian Radiological Association. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial-License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/).

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  • References

  • 1 Lloyd KM, Del Gaudio JM, Hudgins PA. Imaging of skull base cerebrospinal fluid leaks in adults. Radiology 2008;248:725-36.
  • 2 Bullock R, Soares D. Current imaging of cerebrospinal fluid leaks. West Indian Med J 2009;58:362-6.
  • 3 Rajeswaran R, Chandrasekhran A, Mohanty S, Murali K, Joseph S. Role of MR cisternography in the diagnosis of cerebrospinal fluid rhinorrhoea with diagnostic nasal endoscopy and surgical correlation. Indian J Radiol Imaging 2006;16:315-20.
  • 4 Mostafa BE, Khafagi A, Morcos JJ. Combined HRCT and MRI in the detection of CSF rhinorrhea. Skull Base 2004;14:157-62.
  • 5 Goodier M, Lubbe D, Andronikou S, Truter R. Spontaneous lateral sphenoid cerebrospinal fluid fistula: MRI diagnosis. SA Journal of Radiology 2012;16:8-10.
  • 6 Shetty PG, Shroff MM, Sahani DV, Kirtane MV. Evaluation of high resolution CT and MR cisternography in the diagnosis of cerebrospinal fluid fistula. AJNR Am J Neuroradiol 1998;19:633-9.
  • 7 Li YC, Chen CY, Wu KH, Kuo HT, Wu HP. Recurrent Streptococcus Pneumoniae 23 F meningitis due to cerebrospinal fluid leakage from the ear cannel: A case report. BMC Pediatr 2015;15:195.
  • 8 DiChiro G, Girton ME, Frank JA, Dietz MJ, Gansow OA, Wright DC, et al. Cerebrospinal fluid rhinorrhea: Depiction with MR cisternography in dogs. Radiology 1986;160:221-2.