Once we receive your imaging, one of our neuroradiologists will review it. Depending on your case, you will be contacted by one of our coordinators to schedule a consult with one of our neuroradiologists. This consult will be conducted via telephone or telehealth. At this time, a diagnostic and treatment pathway will be discussed, and the Nurse Coordinator will contact you to plan your visit, provide you with pre-procedure instructions, and answer any questions you might have.
You will check in to the clinic one hour prior to your scheduled time. On Day 1, you will undergo a procedure called a CT dynamic myelogram with Dr. Callen’s team. A CT-guided lumbar puncture will be performed to gain access to the spinal fluid space. This involves placing a small needle into the space inside the spinal column. Contrast dye will then be pushed into the spinal canal. You will be positioned so that the contrast dye travels in your spine along the area of interest, and imaging will be performed on both the right and left side. Depending on your treatment plan, you might also have a MRI myelogram immediately following.
Depending on your findings through the diagnostic testing, you will receive either a CT Guided Epidural Blood Patch or a CT Guided Fibrin Patch.
Blood Patching: You will have an IV inserted upon arrival to the pre-procedure room. Once you are in the procedure room, another CT guided Lumbar Puncture will be performed at a specific site. One of our nurses will obtain blood from your IV, and this blood will be injected into the spinal needle.
Fibrin Patching: instead of your blood being placed in the spinal canal, a special form of biosynthetic glue will be injected. Once this is done, you will be monitored in our post-procedure room for an hour or more.
Some leaks cannot be sealed by patching and will require surgical repair. If surgery is required to fix your leak, you will meet with one of our neurosurgeons that specializes in CSF Leak repair to formulate a plan.