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Spinal Imaging Findings Of CSF Hypovolemia Syndrome 2014

Category General Spine Manish Bajaj Toshio Moritani Oscar Pinzon Yutaka Sato Aristides A. Capizzano Tushar Chandra, M.D. Purpose This educational exhibit aims to: 1. Describe pertinent spinal imaging findings of CSF hypovolemia syndrome. 2. Illustrate the pathophysiology of CSF hypovolemia syndrome 3. Discuss role of different modalities used to image spine in diagnosis of CSF hypovolemia. 4. Identify common differential diagnoses to be considered. 5. Suggest optimal management of CSF hypovolemia Materials & Methods Spinal Imaging findings using different modalities including Myelography, CT myelography, MRI, MR myelography, Nuclear cisternography. in patients with diagnosis of CSF hypovolemia were evaluated. Findings were thoroughly assessed and utilized to prepare an eduactional exhibit describing 1.Pathophysiology of CSF hypovolemia syndrome: 2.Common appearances on Spinal Imaging 3.Differential diagnoses 4.Pediatric Vs Adult CSF hypovolemia 5.Brain imaging findings in CSF hypovolemia in brief Results CSF hypovolemia is an important clinicoradiological entity and can be diagnosed on various modalities for imaging spine provided a high index of suspicion is present. •Coexistent findings on brain imaging can support the diagnosis. Conclusion A thorough knowledge of normal pathophysiology, common spinal imaging appearances on various modalities and differential diagnoses can help diagnose CSF hypovolemia with confidence and avoid misdiagnosis. References 1 Case Report: Blood patch for spontaneous intracranial hypotension caused by cerebrospinal fluid leak at C1-2. Inamasu J et al. Clin Neurol Neurosurg. 2007 Oct;109(8):716-9 2 Diagnostic Criteria for Spontaneous Spinal CSF Leaks and Intracranial Hypotension.Schievink WI et al.AJNR Am J Neuroradiol. 2008 May;29(5):853-6 3 Spontaneous Intracranial Hypotension:Spinal MR Findings.Rabin BM et al. AJNR Am J Neuroradiol 19:1034 –1039 4 Spontaneous Spinal Cerebrospinal Fluid Leaks and Intracranial Hypotension. Schievink WI et al.JAMA. 2006 May 17;295(19):2286-96