Imaging of CSF-Venous Fistulas at the High and Low Ends of the Spine: Techniques and Case Examples

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Authors: Ajay A. Madhavan, Michelle L. Kodet, Marcel M. Maya, Wouter I. Schievink, Thien Huynh
Cited by: 1
References: 7

Abstract

ABSTRACT CSF-venous fistulas are a common cause of spontaneous intracranial hypotension. Most CSF-venous fistulas occur in the thoracic spine, and recently described myelographic techniques have been primarily tailored to localize fistulas in this location.1–4 However, a small subset of CSF-venous fistulas can occur at the superior or inferior ends of the spine, ranging from the skull base to the sacrum. In this Video Article, we discuss modifications to decubitus myelography needed to safely and confidently diagnose CSF-venous fistulas at the extremes of the spine, including the skull base and sacrum.5–7 We also show unique case examples of these relatively uncommon leaks, which were found using decubitus digital subtraction or CT myelography with simple technical modifications.

Fields of Study & Subjects

Neurosurgical Procedures and Complications Head and Neck Surgical Oncology Spinal Hematomas and Complications

Publication details

Journal / source
American Journal of Neuroradiology
Publisher
American Society of Neuroradiology (ASNR)
Volume
47
Issue
3
Pages
836–836
Publication date
12 February 2026
Language
EN