The Duke CSF-Venous Fistula Confidence Score: Real-World Application on CT Myelography

CSF-venous fistulas (CVFs) are a common cause of spontaneous intracranial hypotension.^1,2 CVFs can be difficult to identify on myelography given that they are not associated with pooling contrast and are dependent on the identification of small volumes of contrast within diminutive paraspinal veins.^3-5 As a result, there can be uncertainty about the presence or absence of a CVF during CT myelogram interpretation. The Duke CSF-Venous Fistula Confidence Score (DCCS) is a recently published structured reporting system anchored in imaging findings designed to relay the degree of certainty about the presence or absence of a CVF at a particular spinal level.⁶ In this Video Article, we demonstrate real-world practical application of the DCCS using a case-based approach.