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Dinosaur tail sign on spinal MRI in a patient with postdural puncture headache
  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}

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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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