Conebeam CT Myelography for the Detection of Spinal CSF Leaks

Spinal CSF leaks are the primary cause of spontaneous intracranial hypotension, with the most common types of leaks including CSF-venous fistulas and dural tears.1 These leaks necessitate advanced myelographic techniques for accurate localization. Digital subtraction myelography is one such technique used at some institutions.2 Although digital subtraction myelography has excellent temporal and spatial resolution, it does not provide high-resolution cross-sectional images. Here, we describe our technique for conebeam CT myelography performed immediately after digital subtraction myelography, which generates high-resolution cross-sectional images.3-6 We illustrate how this technique enhances detection and characterization of some spinal CSF leaks.