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Cerebrospinal fluid surrounds and protects the brain and the spinal cord, which make up the central nervous system. DISCUSSION[r]
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MILITARY CENTRAL HOSPITAL 108
A CASE WITH CEREBROSPINAL FLUID LEAK DIAGNOSED BY MYELOGRAPHY TECHNIQUE
Nguyen Duy Hai, Pham Minh Chi, Do Duc Cuong Department of Diagnostic Imaging
Department of Diagnostic Imaging
INTRODUCTION
CONTENT
DISCUSSION TECHNIQUE CASE
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Cererospinal fluid (CSF) leak may occur from the nose, from the external auditory canal This is a serious complication lead to meningitis, nervous disorder…
INTRODUCTION
Causes: trauma, skull base fractures, brain tumor, inflamed sinuses, operation accident…
Report a patient who was diagnosed CSF leak after an operation with diagnosis of inflamed sinuses and nasal polyp.
Male, 58 years old
After operation with diagnosis of inflamed sinuses and nasal polyp.
CASE
inflamed sinuses and nasal polyp.
Leak fluid from the nose
CTCT scan,scan, MRI,MRI, ENTENT endoscopyendoscopy without
without detectingdetecting thethe leakingleaking position
position
f i
Performing the Myelography at the Department of Diagnostic Imaging, Militay Central Hospital 108
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Myelography
Myelography isis mostmost commonlycommonly usedused toto detectdetect abnormalitiesabnormalities affectingaffecting the
the spinalspinal cord,cord, thethe spinalspinal canal,canal, thethe spinalspinal nervenerve rootsroots
TECHNIQUE
PREPARATIONPREPARATION
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TECHNIQUE
The lower lumbar spial The lower lumbar spial canal canal L3
L3 L4L4 L4L4 L5L5
TECHNIQUE
L3
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CONTRAST MATERIALS
Mixed Omnipaque/ Physiological saline or distilled water: Mixed Omnipaque/ Physiological saline or distilled water:
7 ml / ml or
7 ml / ml or 8 ml / ml8 ml / ml
TECHNIQUE
Low head
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TECHNIQUE
After 20-30 mins, take CT scan
TECHNIQUE
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TECHNIQUE
- Myelography scan: from the top skull to chin, slide thickness of 3,75 mm - reconstruct 0,625 mm
IMAGES
- The leaking position at the cribriform plate of ethmoid bone.
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Cerebrospinal fluid surrounds and protects the brain and the spinal cord, which make up the central nervous system.
DISCUSSION
CSF leak may lead to meningitis, even death belongs to causes and positon of CSF leak Also, diagnosis CSF leak early determines treatment and prevents the complications.
The myelography technique is indicated for patients with suspicion of CFS when other methods such as CT, MRI or ENT endoscopy could not find out the leaking postion.
• Dural tear
H d h
RISKS
• Headache • Inflammation • Meningitis
• Epidural Abscess • Anaphylaxisp y
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• Take a rest, drink water
MONITORING
• The head and shoulder elevated at 30-45 degrees • Lying on the bed for hours
• Injected position.
•The Myelography technique is a valuable method to detect
CONCLUSION
the CSF leak when other methods such as CT, MRI or ENT endoscopy could not find out the leaking postion.
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