Cisternogram

This test is used to diagnose a cerebrospinal fluid (CSF) leak. It can be ordered with pledgets (for CSF leaks of the head) or without (for spinal leaks or normal-pressure hydrocephalus).

Patients: Please do not eat or drink anything for eight hours before this study. Your physician and interventional radiologist will provide you with other information about the study.

Indications
  • CSF leaks
  • CSF blockages
  • CSF circulation problems
  • Normal-pressure hydrocephalus
Preparation

Patient must be NPO (no food or drink) six hours prior to the lumbar puncture.

Scheduling

Cisternograms with pledgets can be complex to schedule because it requires coordination between the patient's referring physician, the Interventional Radiology Division and the S. Mark Taper Foundation Imaging Center.

Because the patient requires a lumbar puncture to occur six hours before imaging can take place. The lumbar puncture should be performed in the morning, as early as possible.

Here is an outline of the timing of the procedure:

Cisternogram with Pledgets

Beginning:

  • Location: Interventional Radiology Division on the eighth floor of the North Tower of Cedars-Sinai Medical Center
  • Patient receives the radiopharmaceutical through a lumbar puncture (LP)

Two hours after LP:

  • Location: patient's MD's office - NOT the S. Mark Taper Foundation Imaging Center
  • Pledgets placed
  • Location: S. Mark Taper Foundation Imaging Center
  • Blood is drawn

Six hours after LP:

  • Location: S. Mark Taper Foundation Imaging Center
  • Blood drawn again
  • Pledgets removed
  • Imaging performed

24 hours after LP:

  • Location: S. Mark Taper Foundation Imaging Center
  • Imaging may occur a second time, per the request of the physician
Cisternogram Without Pledgets

Beginning:

  • Location: Interventional Radiology Division on the eighth floor of the North Tower of Cedars-Sinai Medical Center
  • Patient receives the radiopharmaceutical through a lumbar puncture (LP)

Six hours after LP:

  • Imaging at the S. Mark Taper Foundation Imaging Center

24 hours after LP:

  • Imaging at the S. Mark Taper Foundation Imaging Center

48 hours after LP:

  • Imaging at the S. Mark Taper Foundation Imaging Center

72 hours after LP:

  • Imaging at the S. Mark Taper Foundation Imaging Center