PT  - JOURNAL ARTICLE
AU  - Mark, I.
AU  - Madhavan, A.
AU  - Oien, M.
AU  - Verdoorn, J.
AU  - Benson, J.C.
AU  - Cutsforth-Gregory, J.
AU  - Brinjikji, W.
AU  - Morris, P.
TI  - Temporal Characteristics of CSF-Venous Fistulas on Digital Subtraction Myelography
AID  - 10.3174/ajnr.A7809
DP  - 2023 Apr 01
TA  - American Journal of Neuroradiology
PG  - 492--495
VI  - 44
IP  - 4
4099  - http://www.ajnr.org/content/44/4/492.short
4100  - http://www.ajnr.org/content/44/4/492.full
SO  - Am. J. Neuroradiol.2023 Apr 01; 44
AB  - BACKGROUND AND PURPOSE: CSF-venous fistula can be diagnosed with multiple myelographic techniques; however, no prior work has characterized the time to contrast opacification and the duration of visualization. The purpose of our study was to evaluate the temporal characteristics of CSF-venous fistula on digital subtraction myelography.MATERIALS AND METHODS: We reviewed the digital subtraction myelography images of 26 patients with CSF-venous fistulas. We evaluated how long the CSF-venous fistula took to opacify after contrast reached the spinal level of interest and how long it remained opacified. Patient demographics, CSF-venous fistula treatment, brain MR imaging findings, CSF-venous fistula spinal level, and CSF-venous fistula laterality were recorded.RESULTS: Eight of the 26 CSF-venous fistulas were seen on both the upper- and lower-FOV digital subtraction myelography, for a total of 34 CSF-venous fistula views evaluated on digital subtraction myelography. The mean time to appearance was 9.1 seconds (range, 0–30 seconds). Twenty-two (84.6%) of the CSF-venous fistulas were on the right. The highest fistula level was C7, while the lowest was T13 (13 rib-bearing vertebral bodies). The most common CSF-venous fistula levels were T6 (4 patients) followed by T8, T10, and T11 (3 patients each). The mean age was 58.3 years (range, 31.7–87.6 years). Sixteen patients were women (61.5%).CONCLUSIONS: This is the first study to report the temporal characteristics of CSF-venous fistulas using digital subtraction myelography. We found that on average, the CSF-venous fistula appeared 9.1 seconds (range, 0–30 seconds) after intrathecal contrast reached the spinal level.CTMCT myelographyCVFCSF-venous fistulaDSMdigital subtraction myelographySIHspontaneous intracranial hypotension