Radionuclide cisternography in spontaneous intracranial hypotension

We report a case of spontaneous intracranial hypotension (SIH) that was investigated using cranial MRI and radionuclide cisternography. Radionuclide imaging was remarkable, showing direct signs of diffuse asymmetric leakage and indirect signs of cerebrospinal fluid (CSF) hypotension consisting of slow CSF circulation to the convexity and rapid appearance of urinary bladder activity. The MRI appearance was also suggestive of SIH, with diffuse meningeal enhancement. Treatment with autologous blood injection at the level of the radionuclide spinal leakage was useful, resulting in disappearance of SIH symptoms.