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Figures
- FIG 1.
Left T5 CVF with contralateral venous drainage and subsequent treatment. A, Axial right lateral decubitus CTM image shows dependent layering of contrast on the right side of the subarachnoid space but no leak. B, Axial left lateral decubitus CTM image shows more uniform distribution of contrast within the subarachnoid space following turning of the patient but also abnormal left radicular veins opacified by dense contrast (dashed arrow) and a hyperdense right paravertebral vein (arrow). C, Axial left lateral decubitus CTM MIP image shows transvertebral intraosseous drainage of the CVF to the right side (arrow). D, Axial posttreatment CT shows contrast-opacified fibrin sealant filling the foramen (arrow) and extending into the epidural space of vertebral canal.
- FIG 2.
Right T5 CVF and subsequent treatment. A, Axial right lateral decubitus CTM image shows a right foraminal meningeal diverticulum and a hyperdense right paraspinal vein (arrows). B, Axial right lateral decubitus CTM image obtained immediately caudal to (A) shows opacification of a small radicular vein (arrow). C, Axial left lateral decubitus CTM image shows no abnormality. D, Axial posttreatment CT shows contrast-opacified fibrin sealant filling the foramen and extending into the epidural space of vertebral canal.
- FIG 3.
Pre- and posttreatment MRIs of the patient in Fig 2. A, Sagittal T1-weighted MR imaging shows brain sag with narrowing of the mamillopontine distance, narrowing of the prepontine cistern, and inferior sloping of the floor of the third ventricle. There is also pituitary enlargement and distension of the straight sinus. B, Resolution of these changes following CT-guided injection of fibrin sealant.
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