The imaging procedures performed to evaluate and treat a possible CSF leak vary among each patient. Some patients may have the entire procedure in CT and others may have parts of the procedure in other areas of radiology.
The radiologist will decide the best plan of care for you. Below is an example of what a patient may undergo for the evaluation and treatment of a CSF leak. This is typically done over a two day period.
DAY 1 APPOINTMENT: “DIAGNOSTIC PROCEDURES”
EXAMPLE: Lumbar Puncture, Myelogram with Total Spine Imaging
BEFORE THE PROCEDURE:
- Discontinue blood thinners – See blood thinner list here. The amount of time you need to stop the blood thinner prior to the appointment depends on the medication you are taking. Please contact our nurse at 684-7770 at least 7 days prior to your appointment to discuss. You should also contact the physician who prescribed the blood thinner to make sure it is safe for you to stop for this procedure.
- Complete the Headache Questionnaire Form and bring with you to your appointment
- Arrive 45 minutes prior to your appointment time
- Bring a driver who must stay in the department until you are released
- Signed consent will be obtained prior to the procedure (inform us of any allergies)
THE PROCEDURE:
- Lumbar Puncture is performed by placing a needle in your lower back to obtain a CSF pressure
- Myelogram is performed by injecting an iodinated contrast agent through the existing needle
- Images of the entire spine are acquired
AFTER THE PROCEDURE:
- You will be monitored in the recovery room for approximately 2 hours
- The radiologist will review all the imaging performed on Day 1
- The results of the Lumbar Puncture and Myelogram will determine what course of treatment is needed the following day
DAY 2 APPOINTMENT: “TREATMENT PROCEDURE”
EXAMPLE: CT-Guided Bloodpatch
BEFORE THE PROCEDURE:
- Do not eat for 8 hours prior to this appointment, you may have something to drink up to 2 hours prior
- Continue holding blood thinners if held for day 1 appointment
- Arrive 45 minutes prior to your appointment time
- Bring a driver who must stay in the department until you are released
- Signed consent will be obtained prior to the procedure (inform us of any allergies)
- An IV may be placed in your arm if sedation is necessary
THE PROCEDURE:
- CT-Guided Bloodpatch is performed by injecting your own blood into the epidural space to form a seal at the leaking site(s)
- Fibrin glue may be used in combination with your blood to seal the leak in certain circumstances, depending on what type of leak you have
AFTER THE PROCEDURE:
- You will be monitored in the recovery room for approximately 2 hours
- Our staff will follow up with you over the next few days
- If from out of town, plan to stay in the area for approximately 1-2 days in case further treatment is needed
- If local, you may go home after being discharged from the recovery room