"CT myelography was first performed in 1976 2 and became the gold standard for imaging the spinal canal and cord until the advent of MRI which has, largely, replaced it. However, ever-increasing CT resolution and the development of dynamic CT myelographic techniques have seen it gain importance in a select group of conditions and remain a viable alternative for patients who cannot have an MRI 1."
"Pre-procedural evaluation"
"In all cases the patient should be slightly head down (Trendelenburg position) to approximately 15-20° 7. This is achieved by using a foam wedge(s) 7."
"some authors 5,6 recommend that medications that lower the seizure threshold (e.g. some antidepressants, antipsychotics, antinausea, and pain medications) should be considered to be witheld for 24-48 hours prior in consultation with the prescribing doctor"
Expected headings
"History"
"Pre-procedural evaluation"
"Conventional CT myelography"
"Dynamic CT myelography"
"If no CSF pooling or leak was identified on MRI of the spine, but clinical symptoms and MRI of the brain are consistent with spontaneous intracranial hypotension then a CSF-venous fistula is likely. The ideal technique in this scenario remains to be fully described 8. Alternatives include: prone dynamic CT myelogram and, if negative, followed by immediate roll into lateral decubitus (allowing contrast to pool dependently); lateral decubitus dynamic CT myelogram with roll into the opposite lateral decubitus; separate injections, one for each side."
"If no CSF pooling or leak was identified on MRI of the spine, but clinical symptoms and MRI of the brain are consistent with spontaneous intracranial hypotension then a CSF-venous fistula is likely. The ideal technique in this scenario remains to be fully described 8. Alternatives include: prone dynamic CT myelogram and, if negative, followed by immediate roll into lateral decubitus (allowing contrast to pool dependently); lateral decubitus dynamic CT myelogram with roll into the opposite lateral decubitus; separate injections, one for each side."