TITLE:
Persistent Epidural Fluid at the Cervical Spine Level, Lessons from Radiology
AUTHORS:
Madhumani N. Rupasingh, Naveen Vanga, Aseem R. Hemmad, Sonya A. Johnson
KEYWORDS:
Post Dural Puncture Headache, MRI Imaging
JOURNAL NAME:
Open Access Library Journal,
Vol.2 No.6,
June
29,
2015
ABSTRACT: Following an accidental dural puncture during the placement of epidural
anesthesia, leakage of cerebrospinal fluid occurs. This leads to tugging on
intracranial pain-sensitive structures and causes a headache that is postural
in nature. According to radiology literature, the presence of retro spinal
fluid collections has been associated with the diagnosis of spontaneous
intracranial hypotension. The characteristic C1-C2 radiographic sign, called
the C1-C2 false localizing sign, can be found on magnetic resonance (MR) images
as a focal area of fluid-like signal intensity and on CT myelograms as a CSF
collection between the spinous processes of C1 and C2. As our case report
demonstrates, this sign is also associated with intracranial hypotension after
lumbar puncture.