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Localization of inactive cerebrospinal fluid fistulas
1Department of Neurosurgery, Richmond Institute for Neurology and Neurosurgery, Beaumont Hospital, Dublin, Republic of Ireland.
Journal of Neurosurgery
|November 1, 1995
Summary
Magnetic resonance (MR) imaging is superior for locating cerebrospinal fluid (CSF) fistulas compared to computerized tomography (CT). MR imaging identified 19 of 21 fistulas, while CT identified only seven, proving MR
Area of Science:
- Neurology
- Radiology
- Neurosurgery
Background:
- Preoperative localization of dural fistulas is crucial for effective treatment.
- Cerebrospinal fluid (CSF) leakage requires accurate identification of the fistula site.
- Various imaging modalities are evaluated for their efficacy in diagnosing CSF fistulas.
Purpose of the Study:
- To evaluate the role of magnetic resonance (MR) imaging in locating dural fistulas.
- To compare the diagnostic accuracy of MR imaging with fine-slice computerized tomography (CT) for CSF leakage.
Main Methods:
- Twenty-one consecutive patients with suspected CSF fistulas were studied.
- Patients underwent both MR imaging and fine-slice CT scans for fistula localization.
- Findings from both imaging modalities were compared against surgical exploration and outcomes.
Main Results:
- MR imaging demonstrated lesions compatible with dural fistulas in 19 out of 21 patients.
- CT scans identified only seven of these lesions, missing a significant number.
- CT was falsely positive in 9.5% of cases, leading to unnecessary surgical exploration in two patients.
Conclusions:
- MR imaging is an essential investigation for patients with suspected dural fistulas.
- MR imaging provides precise localization of CSF fistulas, significantly outperforming CT.
- It should be performed before surgical intervention or assuming natural healing of CSF fistulas.