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Dinosaur tail sign on spinal MRI in a patient with postdural puncture headache
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  1. Keita Sakurai1,
  2. Satoru Morimoto2,
  3. Masashi Kameyama1,
  4. Mitsuhito Mase3
  1. 1Department of Diagnostic Radiology, Tokyo Metropolitan Medical Center of Gerontology, Tokyo, Japan
  2. 2Department of Neurology, Tokyo-to Kenko Choju Iryo Center, Tokyo, Japan
  3. 3Department of Neurosurgery, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
  1. Correspondence to Dr Keita Sakurai, ksak666{at}yahoo.co.jp

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Description

A 68-year-old man presented with cognitive impairment, urinary incontinence and short step gait. These symptoms, together with brain MRI finding, suggested idiopathic normal pressure hydrocephalus. After a spinal tap test to confirm the diagnosis, he suffered from postdural puncture headache. Despite an equivocal finding on spinal MR myelography (MRM), lumbosacral fat-suppressed T2-weighted image (FST2WI) clearly showed the characteristic ‘Dinosaur tail sign’ indicative of cerebrospinal fluid (CSF) leakage (figure 1).1 This pathognomonic sign disappeared on symptom improvement (figure 1). …

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