Cisternogram

What Is a Cisternogram?

A cisternogram uses a radioactive tracer to follow the flow of your cerebral spinal fluid (CSF). Your provider may order this test as follow-up to hydrocephalus or to locate the presence of a CSF leak.

Before the Procedure

Providing safe, quality patient care is our highest priority. For the best experience please properly prepare for your appointment:

• Tell your doctor if you are pregnant or nursing.
• Certain medications cannot be taken prior to this procedure; your doctor will provide instructions if you need to adjust your medication.
• If your procedure is being done to detect a CSF leak, you will be instructed to have small pieces of cotton (pledgets) placed into your nasal passages by a doctor that specializes in ear, nose, and throat conditions. The pledgets detect small amounts of radioactive tracer that may be leaking into your nasal cavity.

During the Procedure

A team of nurses, imaging technologists and a doctor will explain and perform the procedure.

• Imaging Technologist positions you on a cart for X-ray.
• Doctor injects numbing medication into the skin.
• Doctor uses X-ray to guide a needle into the area that surrounds your spine and injects the radioactive tracer.
• Nursing staff monitors your vital signs, such as blood pressure and pulse.
• You will lie on your back for about 2 hours as the tracer moves through the fluid around your spine.
• Day 1 imaging begins about 2-4 hours after the injection and takes approximately 30 minutes.
• You are scheduled to return to nuclear medicine for follow up imaging, up to 3 days following injection.

After the Procedure

• If pledgets were placed, they will be removed 24 hours after injection.
• Do not drive during the remainder of day 1. You should not return to work and should rest for the day.
• To minimize the possibility of a headache, please try to lay down on your back as flat as you can with the exceptions of the ride home, meals, and using the restroom. If a headache begins to develop, you may be instructed to drink large amounts of fluid with caffeine if you are not on fluid restrictions.
• Use pain medications but avoid taking any medications that contain aspirin.
• Remove the band aid at the injection site the next morning and shower or bath as usual.
• The radioactive tracer used for this test is In-111 DTPA.
• A radiologist is a doctor who reads your exam. They will get results to your ordering provider within 5 business days. Your ordering clinic will provide you with the results.
• Notify your care provider if you experience any of the following:
  • A headache that lasts longer than 24 hours
  • Any signs of infection at the injection site (redness, swelling, drainage or fever)
  • Excessive nausea, vomiting, blurred vision, or a stiff neck
• Follow-up care is a key part of your health. Be sure to make and go to all appointments and call your primary care provider if you have questions.