PMC9168387_01
Subdural fluid collections in CT-T2 scanning, patient before EBP under CT guidance.
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F1
Brain MRI showed peri hemispheric, subdural fluid collections, up to 4 mm thick [Figure 1]; reduced distance between the pons and the mammillary bodies to 4 mm, cerebellopontine angle reduced to 55 , and interpeduncular angle reduced to 51 .
CT myelography showing the CSF leakage on the TH12/ L1 level (arrow) on the right side, frontal plane.
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F2
CT myelography with subdural administration of contrast mixed with saline in a ratio of 40/60 showed the fluid leakage site through the spinal nerve root sheath at the level of Th12/L1 intervertebral foramen on the right side [Figures 2 and 3].
CT myelography showing the CSF leakage on the TH12/ L1 level (arrow) on the right side, transverse plane.
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F3
CT myelography with subdural administration of contrast mixed with saline in a ratio of 40/60 showed the fluid leakage site through the spinal nerve root sheath at the level of Th12/L1 intervertebral foramen on the right side [Figures 2 and 3].
Controlling the needle positioning (arrow) during EBP under CT guidance, needle in the intervertebral canal on the right side Th12/L1.
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F4
After confirmation of level Th12/L1 in the CT scout image, we, then, inserted 18G lumbar puncture needle to the intervertebral foramen Th12/L1 under the guidance of CT [Figure 4].
EBP under CT guidance, root sheath covered with patient's venous blood (area in the circle).
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F5
Having previously taken 10 ml of the patient's venous blood, we, then, injected it at the root exit site of the intervertebral foramen under CT guidance [Figure 5].
CT scan performed 1 month after the EBP under CT guidance, complete disappearance of the fluid collections (arrowheads).
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F6
During the follow-up visit, 1 month after hospitalization, the patient was completely free of headache and we found normalization of MRI image [Figure 6].