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Background <p>CT myelography is a definitive diagnostic tool for cerebrospinal fluid leakage. We report a case in which the site of a cerebrospinal fluid leak that had been difficult to identify on CT myelography was fortuitously localized owing to incidental injection of a contrast agent into the subdural space.</p> Case presentation <p>A 37-year-old man developed headache and neck pain following a massage. He was diagnosed with intracranial hypotension, but the exact site of cerebrospinal fluid leakage could not be identified by CT myelography. An epidural blood patch was performed at the Th11/12 level, during which a contrast agent was inadvertently injected into the subdural space, revealing cerebrospinal fluid leakage from the Th2/3 level into the epidural space.</p> Conclusions <p>An unintentional subdural injection of contrast agent resulted in extensive distribution, facilitating the precise identification of the cerebrospinal fluid leakage site.</p>

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Unintentional injection of contrast agent into the subdural space during an epidural blood patch procedure identified the site of cerebrospinal fluid leak: a case report

  • 期刊论文

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  • 发表日期：

    2025年11月28日

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  • Momoko Hattori,
  • Hiroai Okutani,
  • Mayuu Kobata,
  • Daisuke Ishimoto,
  • Yumiko Takao,
  • Nobutaka Kariya,
  • Munetaka Hirose

摘要

Background

CT myelography is a definitive diagnostic tool for cerebrospinal fluid leakage. We report a case in which the site of a cerebrospinal fluid leak that had been difficult to identify on CT myelography was fortuitously localized owing to incidental injection of a contrast agent into the subdural space.

Case presentation

A 37-year-old man developed headache and neck pain following a massage. He was diagnosed with intracranial hypotension, but the exact site of cerebrospinal fluid leakage could not be identified by CT myelography. An epidural blood patch was performed at the Th11/12 level, during which a contrast agent was inadvertently injected into the subdural space, revealing cerebrospinal fluid leakage from the Th2/3 level into the epidural space.

Conclusions

An unintentional subdural injection of contrast agent resulted in extensive distribution, facilitating the precise identification of the cerebrospinal fluid leakage site.