Having a CT-Myelogram? Here's a tip

[msm]

Hi

I just thought i'd post this tip, because for some it might be the difference betwen a leak showing up in a myelogram or not.

In my experience, if one moves around and does a few simple exercises between the injection of the contrast dye and having the CT scan (to avoid confusion: you are usually taken to a second machine for the CT scan), the leak is more likely to show up.

The technicians may tell you to do something like turn over 3 times on the gurney before CT scanning you. For me, this low level of movement was never enough to make my leak evident.

The technicians won't want you to, but insist on standing up. Then lift something up a few times, do a couple of lunges (be careful, obviously), slowly bend over and straighten up a couple of times, do a few internal "pushes" (bearing down as if you are going to the bathroom), and then have your CT scan.

Certainly, don't exert yourself so much as to make yourself sicker, but from what I have seen with myself -- and I'm just a patient, not a doctor -- doing a few small exercises to get that contrast dye "pushed out" makes a difference in the leak site becoming apparent on a scan.. of course it is no guarantee

[Concerned Gal]

Never thought of that. I've also been too frightened in case I get a spinal headache - hehehehhee. wouldn't want that now :D

But obviously not a good idea if you have a big leak and then they have no chance of finding it as you are swamped.

I love this info sharing!!!

[jimc]

Those are good tips. I had a CT myelogram last April, a month after my 2nd craniotomy to fix the leak. The test showed no leakage, but all the doctors now agree I'm still leaking.

All they did to me after injecting the contrast in my spine was to tip the table back and forth a few times. It was a slick metal table, and there was nothing at either end to prevent me from sliding off, which I started to do, head-first. I managed to grab the sides of the table before I flew off the table. Maybe I should have taken the plunge - then the leak probably would have shown itself!

Jim

[Edward]

Gee Jim,

It is little stories like yours that give a person so much faith in the medical professionals who are taking care of us!:rolleyes: Yeah, maybe you are right though. Maybe they were trying to drop you on your head to really open that baby up!:D

-Ed.

[Edward]

Hi,

One question on this subject. Does anyone know how the myelogram differs from a cisternography test?

Thanks...Ed.

[GingerLox]

Hello Ed............

The radionuclide cisternogram refers to the type of isotope (radionuclide dye) that is used in the scanning process. The cisternogram is the type of scanning that is done. In a cisternogram the dye is followed through a series of scans showing how the csf flows in and out of the brain. There are scans taken at several different timed intervals to watch the progress. If there is a leak, the hope is that it will show the fluid outside the normal parameters. This type of scan shows only the dyed fluid and no details of the brain or skull. It only picks up the isotope dye. Many times this test will be done with the insertion of pledgetts into the sinuses, that are removed at the end of the testing period. These pledgetts are tested for the beta-tranferrin protein that is only found in spinal fluid. If they test positive for beta-tranferrin, it will also aid in proving that a csf leak exists.

In a flourescein study........Flouroscent dye is injected into the dura through the spinal column, and then the fluid of the brain turns this fluorescent color. Then, if the fluid leaks out of the nostrils, ears, or down the back of the throat via its external pathway, it will appear flourescent.

A myelogram refers to series of x-ray scans that can be done in conjunction with the flourescein study to look at the flouresein location in the brain to see if the fluid is pooling in a location that is not a normal pathway. This scan will show details of the bones.

i'm not sure if this explanation confused matters. I hope it helped!

GingerLox

[Edward]

Thanks Ginger. That does help. Let me make sure I have this right. So, the cisternography tests are done to try to find IF you have a leak. Whereas the myelogram is done to try to find WHERE the leak is. Does this generally sound right then?

Thanks much...Ed.

[GingerLox]

Dear Ed...............

I am not explaining this well...........I'm sorry!

When you have the opaque contrast dye injected, you can have a myelogram, MRI or a CT scan done with the contrast dye in place. Just as when a doctor decides to use one of these scanning procedures for another injury, each one has its' benefits.

Cistern actually refers to the cisterns of the brain. Cisternography means a radiographic study of the cisterns of the brain, in our case to look for a cranial CSF leak.

Myelogram is a series of xrays done at slightly different angles to gain the best access to all bone structures.
CT scan is best for tissues and organs.
MRI scan is best for more detailed views of tissue and bone with more angles or slices.

The scan that shows only the csf fluid lit up by the dye is a scan that is done as a CSF flow scan, it is done with either CT or MRI, and I do not know how they make only the dye show up in the csf flow scan method of scanning.

So, in my case (at Mayo), when I had the CT radionuclide cistenography, it showed only the CSF and it evaluated the csf flow. At the end they ran a series of scans which I believe might have been a myelogram. It could have been a series of CT scans, I don't know. I also had the pledgett test in conjunction with this test.

I had the Flourescein Test done in Kansas City last year. They did run a couple of CT scans, but from what I understand these were simply to check to see that the flourescent dye had covered the entire brain area (that there wasn't a problem with the fluid getting in.)

How complicated have I made this for you? I dare not ask. I hope this makes a little more sense.



GingerLox

[Edward]

Thanks Ginger. I think I basically understand what you are saying and I appreciate your explanations. I was under the impression that there were certain tests that were more geared at determining IF a person had a leak, and then there were other different tests that were better at determining WHERE the leak actually is. But, I could be wrong about this.

Any word on your test yet?

Take care...Ed.