PREDICTIVE VALUE OF POSTMYELOGRAPHIC COMPUTED-TOMOGRAPHY FOR PATIENTSWITH SEVERE POSTMYELOGRAPHIC HEADACHE

Our goal was to determine if evidence of cerebrospinal fluid (CSF) lea kage on routine postmyelogram computed tomogaphy (CT) of the lumbar sp ine was useful in predicting subsequent development of moderate or sev ere headaches in patients having outpatient myelography. We reviewed p ostmyelogram CT studies of the lower lumbar region of 89 patients for radiogaphic indication of CSF leakage. These patients had outpatient l umbar myelography. We conducted telephone interviews to determine whet her a postmyelogaphic headache occurred. Correlation of CT-verifiable contrast leakage with subsequent development of postmyelogram headache was statistically significant. The early radiographic identification of such patients affords the opportunity for additional measures, such as extended bed confinement, to decrease the morbidity of myelography . Additionally, statistical correlation of such findings should provid e an objective method of evaluating the effectiveness of alterations i n myelographic technique.