Immediate post subarachnoid injection of the radiopharmaceutical--Planar images of the spine
View main image(cl) in a separate image viewer
View second image(cl). Lateral and PA planar scintigrams
View third image(mr). Axial T2 weighted MR images. View MR cine in AVI format.
View fourth image(mr). Sagittal T2 weighted MR images. View MR cine in AVI format.
Full history/Diagnosis is available below
These images demonstrate a widened subarachnoid space in the lumbar and sacral region. There is evidence of bladder activity during the second 10-minute image. The kidneys are clearly visible on the third 10-minute image. The patient was then placed in the supine position and imaging continued. The pattern of activity did not change. There is still some widening of the subarachnoid space in the lower lumbar spine and sacrum. Bladder activity continued to be seen. The patient sat up for 3 minutes, and imaging following this showed no change in the pattern of activity. The patient then walked to the bathroom, urinated, and walked back.
Additional images showed no change in the pattern of subarachnoid activity. Imaging over the head confirmed the subarachnoid location of activity. Lateral imaging in the lower lumbar spine and sacrum showed no activity posterior or anterior to the subarachnoid space.
MRI images delineate the extent of the dural ectasia seen on the scintigraphic images. The apparent decrease signal within the CSF on the axial images is an artifact from the file compression.
The symptoms of dural ectasia vary. They include low back and abdominal pain, headaches and leg pain. Perineal pain and numbness can also occur because of the sacral nerve roots involvement.
Spontaneous intracranial hypotension from a CSF leak in a patient with Marfan’s syndrome. Journal of Neurology, Neurosurgery & Psychiatry. 59(5):516-9. 1995 Nov.
Dural ectasia in the Marfan syndrome: MR and CT findings and criteria. Genet Med. 2000 May-Jun;2(3):173-9.
References and General Discussion of Cerebral Spinal Fluid Leak (Anatomic field:Spine and Contents, Category:Other generalized systemic disorder)
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