Dissimilarity between CT-myelography and RI-cisternography findings in 41 patients with whiplash-associated disorders

Abstract

Some physicians in Japan have insisted that whiplash-associated disorders (WADs) are caused by traumatic cerebrospinal fluid (CSF) leak. Several studies have reported that CSF leak was detected on radioisotope cisternography (RIC) in the lumbosacral region of WAD patients. However, RIC may create false positives by detecting nerve roots or cysts as a CSF leak, whereas the appearance of contrast medium in the epidural space on computerized tomography myelography (CTM) demonstrates a CSF leak directly. We compared the findings of RIC and CTM in 41 patients with WAD. As a result, paraspinal RI accumulation (PSA) was observed in 20 patients, and was located in the lumbosacral region in 19 patients on RIC. In contrast, no epidural collection was observed on CTM, whose findings revealed that root sleeves and cystic structures were observed at the locations in which PSA was noted on RIC. The results indicated that traumatic CSF leak was not observed on the CTM in WAD patients, in which a CSF leak was suspected on the RIC.