Detection of Surgery-related Spinal Cerebrospinal Fluid Leakage Using Magnetic Resonance Myelography

An incidental dural tear resulting in cerebrospinal fluid (CSF) leakage is a complication of spinal surgery, with a reported incidence of between 0.3% and 16% (1, 2). The patient is likely to experience symptoms of CSF hypovolemia, including postural headache plus nausea, vomiting, pain or tightness in the neck or back, dizziness, diplopia, photophobia, tinnitus, and/or blurred vision. The usual treatment of CSF leakage consists of drainage of the CSF through a subarachnoid catheter (3) and surgical repair of the dural tear (4), although an epidural blood patch may also be used (5). To provide appropriate treatment, it is essential to detect the exact site of CSF leakage. Among the diagnostic modalities used to determine the site of CSF leakage are magnetic resonance (MR) imaging, computed tomographic (CT) cisternography, and radioisotope cisternography. Here, we describe two patients with surgery-related CSF leakage in whom the leakage sites were accurately detected on MR myelography.