Great question! Still unknown. #workinprogress. Some pts do respond to patching. Many with large spiculated disc osteophytes require surgery. I try patching first, but have lower threshold for surgery. #assr #ajnr

Here's the CT guided needle approach (not for the faint of heart): bit.ly/2ZK5mFl

We desperately need prospective RCTs evaluating efficacy of EBP and surgery. 1st need to prove efficacy: 40% sham response in surgical RCTs... Eventually need comparative RCTs. There are currently 0 published trials! #assr #ajnr

Great question and thanks for asking! PATCH feasibility trial (single center at Duke) - closed. Demonstrates excellent feasibility for enrollment and blinding. On to multi-center RCT! #assr #asnr

Peter Kranz Tim Amrhein, MD AJNR There is a downloadable PDF of new codes here: spinalcsfleak.org/diagnostic-cod…

SIH is likely WAY more common than currently recognized. Be on the lookout in your clinical practice... it may be seeing you, if you're not seeing it... #assr #ajnr

Thanks so much for having us! This was a lot of fun. Happy to continue the conversation anytime #SIH #assr #ajnr Peter Kranz AJNR American Society of Spine Radiology (ASSR) spinalCSFleak

Absolutely! Critical. Although with pervasive misdiagnosis we will still underestimate...

SIS just published guidelines recommending no corticosteroid injections for the two weeks prior to, and the one week following, a vaccination dose: spineintervention.org/news/551084/Co…

The 2021 “Headache: The Highs & Lows of CSF Pressure Problems” virtual meeting, Duke Radiology March 13-14, 2021. Only 1 week left to register! More info & online registration: radiology.duke.edu/courses/headac… #csfleak #spinalcsfleak #SIH Peter Kranz Tim Amrhein, MD linda gray

...still time to register! The 2021 “Headache: The Highs & Lows of CSF Pressure Problems” virtual meeting, Duke Radiology March 13-14, 2021. More info & online registration: radiology.duke.edu/courses/headac… #csfleak #spinalcsfleak #SIH Peter Kranz Tim Amrhein, MD linda gray

We ⁦spinalCSFleak⁩ are looking forward to seeing you in October #SIH #CSFleak

Ashwani Gore received the ASSR research grant last year for identifying the primary pain generator in patients with axial facetogenic neck pain using 18(F)-NaF PET/MRI and appreciated it jumpstarting his early career . Now it's your turn! Apply today! static1.squarespace.com/static/5c883a9…

CALL FOR APPLICATIONS: The Junior Fellows Program at HAI is a prestigious program for early-career scholars who are seeking to conduct innovative and interdisciplinary AI research with unparalleled opportunities for impact. Apply by November 15, 2021: stanford.io/3yHxsQd

.American Society of Spine Radiology (ASSR) Research Grant application is open! Funding to advance the understanding, dianosis, & treatment of spine pathology. theassr.org/assr-research-… Applications due October 1. Deadline in 4 weeks! #Spine #Radiology #Research #NeuroRad Lubdha Shah Tim Amrhein, MD Vinil Shah

New Instagram post! instagram.com/p/CcDXrj0rlZo/… Popping the balloon: Abrupt onset of a spinal #CSFleak & SpontaneousIntracranialHypotension in #IntrancranialHypertension, a case report Gary Sulioti, linda gray Tim Amrhein, MD Manuscript link ⬇️ #InstagramThursdays #HeadacheRFS

Photon-counting CT visualizes cerebrospinal fluid (CSF) venous fistula (CVF) better than traditional imaging approaches such as CT myelography or MRI, according to a report in JAMA Neurology led by Dr. Fides Schwartz of Duke Radiology. #radiology bit.ly/3MirxZb

DECT, PCCT? There's something here... this has been very helpful for a subset of our patients: jamanetwork.com/journals/jaman…

PCCT's superior resolution and signal to noise ratio may improve sensitivity for detection of occult CVFs in patients with definitive SIH. Had another case just today where PCCT saved the day! JAMA Neurology

Duke and Mayo team SIH collab in the running for 2024 AJNR Journal Award! Vote here: ajnr.org/awards Efficacy of Epidural Blood Patching or Surgery in SIH: A Systematic Review and Evidence Map pubmed.ncbi.nlm.nih.gov/37202114/ Duke Radiology DukeNeuroradiology Mayo Clinic Radiology