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Spinal CSF leak

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  • 70-year-old patient with orthostatic headaches and transient bilateral 6th nerve palsies. The patient had a multi-level thoracic laminectomy for a compressive arachnoid cyst many years prior.
  • CT myelography showed a rapidly filling small ventral epidural leak (red arrow).
  • More apparent on later phase imaging, the ventral leak was associated with a small osteophyte (blue arrow).

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  • A 70-year-old patient presented with tinnitus and dizziness.
  • MRI showed extensive superficial siderosis above and below the tentorium.
  • While the patient had no headache, given the distribution of siderosis, a CSF leak was suspected.
  • MRI of the spine showed a longitudinally extensive ventral epidural collection, indicating a CSF leak.