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Abnormal Cisternogram Associated with Diamox Therapy

Harvard Medical School and Peter Bent Brigham Hospital, Boston, Massachusetts

Correspondence: For reprints contact: Barbara J. McNeil, Dept. of Radiology, Harvard Medical School, 25 Shattuck St., Boston, MA 02115.

ABSTRACT

A cisternogram characteristic of normal-pressure hydrocephalus was obtained from a patient on Diamox who was being evaluated for rapid mental deterioration. A repeat cisternogram after Diamox was discontinued was nearly normal. We hypothesize that the initial abnormality resulted from reduced cerebrospinal fluid production caused by carbonic anhydrase inhibition; this defect (reduced flow) led to a net reflux of tracer into the ventricles. The reflux is believed to be due to the reduction of bulk cerebrospinal fluid flow from the ventricles.