Cisternogram - Nuclear Medicine

A cisternogram uses a radioactive substance (or tracer) to demonstrate cerebral spinal fluid (CSF) dynamics.

Indications for a cisternogram might be to determine if a patient may have a form of non-communicating hydrocephalus or to localize the presence of a CSF leak.

Before Your Procedure

• Before the test, you should tell your physician if you are pregnant or nurse.
• If your procedure is being done to detect a CSF leak, you may be asked to have small pieces of cotton (pledgets) placed inside your nasal passages by a doctor that specializes in ear, nose and throat conditions.
• The pledgets (usually three in each nostril) have a small string attached that will protrude from your nose and are taped to your cheek.
• Some medications may increase your risk of bleeding after your procedure. Please check with your doctor about possibly holding medications such as aspirin, Coumadin (warfarin), Ticlid, Pletal, Aggrenox, Plavix and NSAIDs, such as naproxen and ibuprofen before your procedure.
• Please hold these medications as directed. You may resume your medication the day after your procedure.

During Your Procedure

• During the exam, a radiologist will use X-ray guidance to place a needle into the area that surrounds your spine. The area chosen will be injected with a numbing medication.
• Then the radiologist injects the radioactive tracer.
• The tracer will take some time to move through the intrathecal space, so you will be taken back to the nuclear medicine department.
• There you will rest, lying down for two to four hours.
• You will then be brought to the imaging room and positioned on the table under the camera.
• The scan takes about 30-60 minutes.
• You will be scheduled for serial scans starting about 24 hours, 48 hours and possibly 72 hours after your initial scan.
• If you had pledgets placed, they will be removed at the 24-hour scan.

After Your Procedure

• Go home and rest the remainder of the day
• Do not drive the remainder of the day
• To minimize the possibility of a headache after the lumbar puncture, please stay on bed rest, lying flat with no more than one pillow under your head. You may be up in the car for the ride home, up for meals and to go to the bathroom
• If a headache begins to develop, lie down, and if you are not on a fluid restriction, drink a large amount of fluid with caffeine. Two liters of Coke, Mountain Dew or Pepsi contains one gram of caffeine, which is the recommended dose. You may use pain medication but avoid medications containing aspirin
• You may remove the band aid at the injection site in the morning. You also may take a shower or bath the day after your exam.

Notify Your Physician if You Experience

• Headache that lasts longer than 24 hours
• Any signs of infection at the puncture site such as redness, swelling, drainage or fever
• Excessive nausea, vomiting, blurred vision or a stiff neck

The radioactive substance given during this procedure is In-111 DTPA.

Thank you for letting us perform your examination. Your images will be interpreted by Regional Diagnostic Radiologists (RDR). It is our goal to have the report available to your physician within 24 hours.

Your physician has requested we inform you that it may take him/her 3-5 working days before they notify you with results. If you have not been notified by the fifth working day, you may call your physician for the results. If you already have a follow up appointment scheduled with your physician, they may wait to inform you of your results at that time.

If you have any questions about your examination, please call your doctor.