| Immediate Resolution of Spontaneous Intracranial Hypotension(SIH) after Radioisotope(RI) Cisternography |
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Seung-Young Jeong, Eun-Jeong Koh, Ha-Young Choi |
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Department of Neurosurgery, Research Institute of Clinical Medicine, Chonbuk National University Medical School and Hospital, Jeonju, Korea |
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| Abstract |
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Spontaneous intracranial hypotension (SIH) is rare cause of orthostatic headache due to a cerebrospinal fluid (CSF) hypotension. Fluid therapy, lumbar epidural blood-patch (LEBP) or epidural saline infusion is effective treatment, however, the standard therapeutic strategy is not known. We present a patient immediately improved after radioisotope (RI) cisternography. A 64-yearold woman was admitted to our hospital for severe orthostatic headache. Her intracranial pressure (ICP) was 4cmH2O. Her MRI
revealed subdural hygroma on left frontal area and diffuse pachymeningeal enhancement. We performed RI cisternography to evaluate the CSF leakage and we found the CSF leakage at thoracic level. After RI cisternography, her headache was improved directly. We rechecked RI cisternogram after 10 days. The second RI cisternography revealed no CSF leakage. We suggest that the retained radioisotope induced arachnoiditis and this arachnoiditis healed the CSF leakage site. RI cisternography is considered as a diagnostic and therapeutic modality despite the one experience. |
| Key Words:
Intracranial hypotension, Radioisotopes, Cisternography. |
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