What Is a Cisternogram?

A cisternogram uses a radioactive tracer to follow the flow of your cerebral spinal fluid (CSF). Your provider may order this test as follow-up to hydrocephalus or to locate the presence of a CSF leak.

Before the Procedure

Providing safe, quality patient care is our highest priority. For the best experience please properly prepare for your appointment:

  • Tell your doctor if you are pregnant or nursing.
  • Certain medications cannot be taken prior to this procedure; your doctor will provide instructions if you need to adjust your medication.
  • If your procedure is being done to detect a CSF leak, you will be instructed to have small pieces of cotton (pledgets) placed into your nasal passages by a doctor that specializes in ear, nose, and throat conditions. The pledgets detect small amounts of radioactive tracer that may be leaking into your nasal cavity.
  • Do not bring children with you to your appointment. For their safety children are not allowed to accompany you in the exam room. Staff are unable to monitor children.

During the Procedure

A team of nurses, imaging technologists and a doctor will explain and perform the procedure.

  • Imaging Technologist positions you on a cart for X-ray.
  • Doctor injects numbing medication into the skin.
  • Doctor uses X-ray to guide a needle into the area that surrounds your spine and injects the radioactive tracer.
  • Nursing staff monitors your vital signs, such as blood pressure and pulse.
  • You will lie on your back for about 2 hours as the tracer moves through the fluid around your spine.
  • Day 1 imaging begins about 2-4 hours after the injection and takes approximately 30 minutes.
  • You are scheduled to return to nuclear medicine for follow up imaging, up to 3 days following injection.

After the Procedure

  • If pledgets were placed, they will be removed 24 hours after injection.
  • Do not drive during the remainder of day 1. You should not return to work and should rest for the day.
  • To minimize the possibility of a headache, please try to lay down on your back as flat as you can with the exceptions of the ride home, meals, and using the restroom. If a headache begins to develop, you may be instructed to drink large amounts of fluid with caffeine if you are not on fluid restrictions.
  • Use pain medications but avoid taking any medications that contain aspirin.
  • Remove the band aid at the injection site the next morning and shower or bath as usual.
  • The radioactive tracer used for this test is In-111 DTPA.
  • A radiologist is a doctor who reads your exam. They will get results to your ordering provider within 5 business days. Your ordering clinic will provide you with the results.
  • Notify your care provider if you experience any of the following:
    • A headache that lasts longer than 24 hours
    • Any signs of infection at the injection site (redness, swelling, drainage or fever)
    • Excessive nausea, vomiting, blurred vision, or a stiff neck
  • Follow-up care is a key part of your health. Be sure to make and go to all appointments and call your primary care provider if you have questions.

If you have any questions or concerns, please contact your provider.

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