Spontaneous Intracranial Hypotension: Characteristic Findings of Radionuclide Cisternography Using In-111 DTPA

The authors describe two patients with spontaneous intracranial hypotension. The patients had the cardinal features of a postural headache. In both patients, radionuclide cisternography revealed cerebrospinal fluid (CSF) leakage at the cervicothoracic junction and early accumulation of isotope in the urinary tract. Postmyelography CT scans showed no underlying structural abnormalities. Both patients were treated successfully by intravenous infusion of low-osmolarity fluid. Radionuclide cisternography obtained after treatment in one of the patients showed that the CSF leak had disappeared. Radionuclide cisternography enabled the causes of spontaneous intracranial hypotension to be differentiated and visualized the sites of CSF leakage. It was also useful for evaluating changes in a CSF leak after treatment.