Abstract
Purpose
Dural tears are a common cause of spontaneous spinal CSF leaks. The majority of such leaks occur ventrally along the thecal sac, typically due to ventral osseous spicules that cause a rent in the dura. A minority of dural leaks are posterolateral in location. These leaks usually do not have an identifiable anatomic cause. We have anecdotally observed cases of posterolateral leaks caused by osseous spicules and sought to describe this phenomenon.
Methods
We retrospectively reviewed our imaging database, searching for cases of posterolateral CSF leaks caused by osseous spicules. We identified and included three such patients and reviewed imaging and clinical information from each patient.
Results
All three patients had been diagnosed using hyperdynamic CT myelography or conventional CT myelography. Their imaging showed dorsal epidural fluid collections that were related to posterolateral leaks adjacent to dorsal osseous spicules.
Conclusion
Dorsal osseous spicules have the potential to cause posterolateral CSF leaks.
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Data availability
Data regarding the study are available upon request.
Abbreviations
- CSF:
-
Cerebrospinal fluid
- CT:
-
Computed tomography
- ICHD-3:
-
International Classification of Headache Disorders-3
- SIH:
-
Spontaneous intracranial hypotension
- SLEC:
-
Spinal longitudinal extradural collection
References
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All procedures performed in the studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.
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Madhavan, A.A., Shlapak, D.P., Benson, J.C. et al. Osseous spicules of the posterior elements causing fast cerebrospinal fluid leaks. Neuroradiology 64, 1689–1693 (2022). https://doi.org/10.1007/s00234-022-02943-8
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DOI: https://doi.org/10.1007/s00234-022-02943-8