Radionuclide cisternography in the diagnosis and management of cerebrospinal fluid leaks: the test of choice.

While leakage of cerebrospinal fluid is an intermittent and usually short-lived phenomenon, it may be fatal. The difficulty of making this diagnosis has led to the adoption of many diagnostic procedures. Fifteen patients have been studied by radionuclide cisternography with the concomitant use of nasal pledgets. Six of the studies showed cerebrospinal fluid leakage; the sensitivity of the technique was 100%. The site of leakage was confirmed surgically in three of the patients. No other technique offers comparable sensitivity with high patient acceptance and low morbidity.