Course: Cerebrospinal Fluid Venous Fistula Imaging with Ultrahigh-Resolution Cone-Beam Computed Tomography
CME Credits: 1.00
Released: 2023-06-12
A 78-year-old man with spontaneous intracranial hypotension (SIH) presented with orthostatic headache and hearing and memory impairment for the past 7 months. External head magnetic resonance imaging disclosed high probability for SIH, including subdural hematomas, but further examinations, such as spinal magnetic resonance imaging and computed tomography (CT) myelography in supine position, failed to show the site of cerebrospinal fluid (CSF) leakage. Four epidural blood patches improved symptoms only temporarily. An underlying CSF venous fistula (CVF) was detected by ultrahigh-resolution cone-beam CT (UHR-CBCT) myelography—to our knowledge, the first time a CVF was visualized with ultrahigh spatial resolution (; A). Recent investigations have also reported improved CVF imaging by photon counting and dual-energy CT.
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