"Density and Time Characteristics of CSF-Venous Fistulas on CT Myelography in Patients with Spontaneous Intracranial Hypotension" doi.org/10.3174/ajnr... @The_ASSR @dgleao @TimAmrheinMD @PeterGKranz #CSFLeak
Peter Kranz, M.D.
@petergkranz.bsky.social
Division Chief of Neuroradiology at Duke University Medical Center. Research in #spinalCSFleak #SIH. Tweets my own. No discussion of individual patient care. #radsky #neurorad
"Safety and Technical Performance of Bilateral Decubitus CT Myelography Using Standard versus Increased Intrathecal Iodinated Contrast Volume" doi.org/10.3174/ajnr... @dgleao @PeterGKranz @The_ASSR #CSFLeak #EditorsChoice
"While we found a statistically significant higher renal contrast excretion in patients with SIH compared with patients without SIH during early-phase CTM, no useful threshold value could be established that could reliably distinguish these groups with both high sensitivity and high specificity."
"Diagnostic Performance of Renal Contrast Excretion on Early-Phase CT Myelography in Spontaneous Intracranial Hypotension" doi.org/10.3174/ajnr...
📄New paper on ICP monitoring in pts with orthostatic HA and negative imaging found that most common identifiable pressure issue was high pressure (!) “3 patients had low ICP (8%) and 6 patients had high ICP (16%). The remaining [had neither] (76%). 🤔 pubmed.ncbi.nlm.nih.gov/39905291/
Intracranial pressure monitoring in patients with spontaneous onset of orthostatic headache - PubMed
Portions of this work were presented in abstract and oral presentation form at the Twenty-eighth Anglo-Dutch Migraine Association meeting (08/06/2018), the Tenth Meeting of the International Society f...
pubmed.ncbi.nlm.nih.gov
So what exactly makes a headache orthostatic anyway? 📄 New paper alert 📄 journals.sagepub.com/doi/full/10....
Sage Journals: Discover world-class research
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journals.sagepub.com
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Most EBPs in the community are performed without imaging guidance. Case report of how an intact plica dorsalis mediana prevented bilateral spread of blood, necessitating a second EBP under imaging. Consider when EBP for PDPH “fails.” scholar.google.com/scholar_url?...
scholar.google.com
📄 New Paper Alert! 📄 “Flow Void Sign”: Flow Artifact on T2-Weighted MRI Can Be an Indicator of Dural Defect Location in Ventral Type 1 Spinal CSF Leaks Congrats to @neuroradlal.bsky.social, @dgleao.bsky.social , David Butteriss, @brainscandan.bsky.social - super useful - I'm a believer!!
“Flow Void Sign”: Flow Artifact on T2-Weighted MRI Can Be an Indicator of Dural Defect Location in Ventral Type 1 Spinal CSF Leaks
Patients with spontaneous intracranial hypotension caused by type 1 dural defects typically have an epidural fluid collection on MRI. Still, the location of the defect is not usually readily identifia...
ajnr.org
Headache that worsens upon standing may prompt suspicion for CSF leak. But there is a normal sharp spike in CSF pressure immediately upon standing. In some patients with IIH or RIH, this can paradoxically cause HA upon standing, tho usually transient. Fig: PMID 34715658
Fascinating series of articles on CTD in Neurology in #FrontiersinNeurology including #CSFleak and orthostatic HA. Great discussion and hypotheses- but surprising how little primary data underpins our current understanding. #knownunknowns www.frontiersin.org/research-top...
Neurology and Connective Tissue
Connective tissue compromise, as is seen in the heritable connective tissue disorders collectively called Ehlers-Danlos Syndrome, but also acquired connective tissue disorders as can be seen in autoim...
frontiersin.org
Don’t want to read that spine case? Come to THIS session at #RSNA2024! Mon Dec 2, 8-9am, Rm S406B > Is this spinal finding actionable? > Is this spinal infection? > What am I looking for on this CSF leak spine imaging? > What am I looking for on this postop spine imaging?
