Teaching NeuroImage: Ultrafast Dynamic CT Myelography for the Identification of Leakage Level in Multiple Meningeal Diverticula.

A 26-year-old woman presented with symptoms of orthostatic headache for 1 year that temporarily improved after 2 nontargeted epidural blood patches. Despite this intervention, she had persistent radiologic signs of CSF hypotension (Figure 1) and multiple meningeal diverticula on conventional CT myelography (Figure 2, A and C). Ultrafast dynamic CT myelography confirmed only 1 T8-T9 right-side meningeal diverticula in the initial phases (Figure 2, B and D), with later opacification of the remaining diverticula. Surgical treatment resulted in symptom resolution.