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Radionuclide cisternogram
CSF flow scan; Cisternogram
A radionuclide cisternogram is a nuclear scan test. It is used to diagnose problems with the flow of spinal fluid.
How the Test is Performed
A spinal tap ( lumbar puncture ) is done first. Small amounts of radioactive material, called a radioisotope, are injected into the fluid within the spine.
Lumbar puncture
Cerebrospinal fluid (CSF) collection is a test to look at the fluid that surrounds the brain and spinal cord. CSF acts as a cushion, protecting the b...
You will then be scanned 4 to 6 hours after getting the injection. A special camera takes images that show how the radioactive materials travel with the cerebrospinal fluid through the spine. The images also show if the fluid leaks outside the spine or brain.
You will be scanned again 24 hours after injection. You may need additional scans possibly at 48 and 72 hours after injection.
How to Prepare for the Test
Most of the time, you do not need to prepare for this test. Your health care provider may give you a medicine to calm your nerves if you are very anxious. You will sign a consent form before the test.
You will wear a hospital gown during the scan so the doctors have access to your spine. You will also need to remove jewelry or metallic objects before the scan.
How the Test will Feel
Numbing medicine will be put on your lower back before the lumbar puncture. However, many people find lumbar puncture somewhat uncomfortable. This is often due to the pressure on the spine when the needle is inserted.
The scan is painless, although the table may be cold or hard. No discomfort is produced by the radioisotope or the scanner.
Why the Test is Performed
The test is performed to detect problems with flow of spinal fluid and spinal fluid leaks. In some cases, there may be a concern the CSF fluid is leaking after a trauma to the head or a surgery in the head. This test will be done to diagnose the leak.
Normal Results
A normal value indicates normal circulation of CSF through all parts of the brain and spinal cord.
What Abnormal Results Mean
An abnormal result indicates disorders of CSF circulation. These disorders may include:
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Hydrocephalus
or dilated spaces in your brain due to an obstruction
Hydrocephalus
Hydrocephalus is a buildup of fluid inside the skull that leads to brain swelling. Hydrocephalus means "water on the brain. "
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CSF leak
CSF leak
A CSF leak is an escape of the fluid that surrounds the brain and spinal cord. This fluid is called the cerebrospinal fluid (CSF).
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Normal pressure hydrocephalus (NPH)
Normal pressure hydrocephalus (NPH)
Hydrocephalus is a buildup of spinal fluid inside the fluid chambers of the brain. Hydrocephalus means "water on the brain. "Normal pressure hydroce...
ImageRead Article Now Book Mark Article - Whether or not a CSF shunt is open or blocked
Risks
Risks associated with a lumbar puncture include pain at the injection site, bleeding, and infection. There is also a very rare chance of nerve damage.
The amount of radiation used during the nuclear scan is very small. Almost all of the radiation is gone within a few days. There are no known cases of the radioisotope causing harm to the person getting the scan. However, as with any radiation exposure, caution is advised if you are pregnant or breastfeeding.
Very rarely, a person may have an allergic reaction to the radioisotope used during the scan. This may include a serious anaphylactic reaction .
Allergic reaction
Allergic reactions are sensitivities to substances called allergens that come into contact with the skin, nose, eyes, respiratory tract, and gastroin...
Anaphylactic reaction
Anaphylaxis is a life-threatening type of allergic reaction.
Considerations
You should lie flat after the lumbar puncture. This can help prevent headache from the lumbar puncture. No other special care is necessary.
References
Bartleson JD, Black DF, Swanson JW. Cranial and facial pain. In: Daroff RB, Fenichel GM, Jankovic J, Mazziotta JC, eds. Bradley's Neurology in Clinical Practice . 6th ed. Philadelphia, PA: Elsevier Saunders; 2012:chap 18.
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Lumbar puncture - illustration
Cerebral spinal fluid (CSF) is a clear fluid that circulates in the space surrounding the spinal cord and brain. CSF protects the brain and spinal cord from injury by acting like a liquid cushion. CSF is usually obtained through a lumbar puncture (spinal tap). During the procedure, a needle is inserted usually between the 3rd and 4th lumbar vertebrae and the CSF fluid is collected for testing
Lumbar puncture
illustration
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Lumbar puncture - illustration
Cerebral spinal fluid (CSF) is a clear fluid that circulates in the space surrounding the spinal cord and brain. CSF protects the brain and spinal cord from injury by acting like a liquid cushion. CSF is usually obtained through a lumbar puncture (spinal tap). During the procedure, a needle is inserted usually between the 3rd and 4th lumbar vertebrae and the CSF fluid is collected for testing
Lumbar puncture
illustration
Review Date: 7/4/2015
Reviewed By: Jason Levy, MD, Northside Radiology Associates, Atlanta, GA. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.
