Background

With improved recognition by clinicians of spontaneous intracranial hypotension (SIH) caused by spinal CSF leaks, there has been an increase in demand for CT-guided diagnostic and therapeutic procedures for this condition. Neuroradiographers play a critical role in the successful conduct of these procedures, but there is a lack of widespread availability in the UK due in part to a lack of familiarity with how to perform them.

Objective

This educational poster presentation will illustrate the essentials of the procedural aspects of the various types of myelography and CT guided treatment options for these patients including patching. Tips and tricks we have learned through our departments' experience of these studies that improve diagnostic yield and enhance patient comfort will be presented.

Methods

For each procedure, details will be given regarding all aspects of the neuroradiographer's role in these procedures. This includes patient positioning, necessary equipment and acquisition, including optimisation of radiation dose, image reconstruction and reformatting.

Results

Illustrative examples of positive CT myelograms demonstrating the different types of spinal CSF leak and their subsequent CT-guided treatment will be presented.

Conclusions

CT-guided diagnostic and interventional spinal procedures for patients who have SIH require careful attention to detail to optimise diagnostic yield and increase the likelihood of successful therapeutic response. Neuroradiographers occupy a central and essential position in ensuring the success of these procedures.