"The key to the diagnosis is identifying myelographic contrast opacifying lymphatic vessels or chains, with eventual contrast opacification of the thoracic duct. This can be achieved, similarly to investigation of CSF-venous fistulas, either with cross-sectional imaging (CT myelography or MR myelography) or fluoroscopy (digital subtraction myelography) 1-3. MR lymphangiography should also be performed to investigate for a contributing lymphatic or venolymphatic spinal malformation, and to pre-operatively assess lymphatic drainage pathways 1."
"Off-label warning: the use of gadolinium-based contrast agents for intrathecal administration is not approved by regulatory agencies such as the FDA. Read more: intrathecal gadolinium."
"Similar to imaging of CSF-venous fistulas, and unlike other cases of spontaneous intracranial hypotension due to CSF leaks, no accumulation of CSF outside of the dura can be identified (e.g. no spinal longitudinal epidural collections). However, other features of spontaneous intracranial hypotension (e.g. pachymeningeal enhancement, increased venous blood volume, subdural effusions, sagging brainstem and acquired tonsillar ectopia, etc.) may be present 1-3,9."
"Off-label warning: the use of gadolinium-based contrast agents for intrathecal administration is not approved by regulatory agencies such as the FDA. Read more: intrathecal gadolinium."
"Off-label warning: the use of gadolinium-based contrast agents for intrathecal administration is not approved by regulatory agencies such as the FDA. Read more: intrathecal gadolinium."
"Similar to imaging of CSF-venous fistulas, and unlike other cases of spontaneous intracranial hypotension due to CSF leaks, no accumulation of CSF outside of the dura can be identified (e.g. no spinal longitudinal epidural collections). However, other features of spontaneous intracranial hypotension (e.g. pachymeningeal enhancement, increased venous blood volume, subdural effusions, sagging brainstem and acquired tonsillar ectopia, etc.) may be present 1-3,9."