CT-Guided Epidural Contrast Injection for the Identification of Dural Defects

Ian T Mark; Michael Oien; John C Benson; Jared Verdoorn; Ben Johnson-Tesch; D K Kim; Jeremy Cutsforth-Gregory; Ajay A Madhavan

doi:10.3174/ajnr.A8437

CT-Guided Epidural Contrast Injection for the Identification of Dural Defects

AJNR Am J Neuroradiol. 2025 Jan 8;46(1):207-210. doi: 10.3174/ajnr.A8437.

Authors

Ian T Mark¹, Michael Oien², John C Benson², Jared Verdoorn², Ben Johnson-Tesch², D K Kim², Jeremy Cutsforth-Gregory³, Ajay A Madhavan²

Affiliations

¹ From the Department of Radiology (I.T.M., M.O., J.B., J.V., B.J.-T., D.K.K., A.A.M), Mayo Clinic, Rochester, Minnesota [email protected].
² From the Department of Radiology (I.T.M., M.O., J.B., J.V., B.J.-T., D.K.K., A.A.M), Mayo Clinic, Rochester, Minnesota.
³ Department of Neurology (J.C.-G.), Mayo Clinic, Rochester, Minnesota.

PMID: 39134368
PMCID: PMC11735425 (available on 2026-01-01)
DOI: 10.3174/ajnr.A8437

Abstract

Post-dural puncture headache is an increasingly recognized cause of chronic headache. Outside of clinical history and myelography that requires an additional dural puncture, there is no reliable diagnostic test to evaluate for persistent dural defects. We describe the injection of iodinated contrast into the dorsal epidural space under CT guidance in 5 patients as a potential tool to visualize persistent dural defects.

Publication types

Case Reports

MeSH terms

Adult
Aged
Contrast Media* / administration & dosage
Dura Mater* / diagnostic imaging
Epidural Space / diagnostic imaging
Female
Humans
Injections, Epidural / adverse effects
Injections, Epidural / methods
Male
Middle Aged
Myelography / methods
Post-Dural Puncture Headache / diagnostic imaging
Tomography, X-Ray Computed* / methods

Substances

Contrast Media