CT-Guided Epidural Contrast Injection for the Identification of Dural Defects

ABSTRACT Post-dural puncture headache (PDPH) is an increasingly recognized cause of chronic headache. Outside of clinical history and myelography that requires an additional dural puncture, there is no reliable diagnostic test to evaluate for persistent dural defects. We describe the injection of iodinated contrast into the dorsal epidural space under CT guidance in five patients as a potential tool to visualize persistent dural defects. ABBREVIATIONS: PDPH = post-dural puncture headache; SIH = spontaneous intracranial hypotension; DSM = digital subtraction myelography; CTM = CT myelography