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Controlled Overpressure Cisternography to Localize Cerebrospinal Fluid Rhinorrhea

Rikshospitalet, Oslo, Norway

Correspondence: For reprints contact: Bjørn Magnaes, Dept. of Neurosurgery, Rikshospitalet, Oslo 1, Norway.

ABSTRACT

Cerebrospinal fluid (CSF) rhinorrhea is often intermittent, thus complicating the cisternographic localization of the leakage. In four patients studied, this difficulty was overcome by lumbar infusion of artificial CSF to which a bolus of radionuclide was added. The tracer was moved in bulk to the basal cisterns, and the rise in CSF pressure elicited a profuse rhinorrhea. Sequential imaging was started during the infusion, and prompt identification of the site of leakage was easily obtained. Special precautions must be followed when this technique of overpressure is used.