Comment on Aydin, K., et al: Localization of cerebrospinal fliud leaks by gadolinium-enhanced magnetic resonance cisternography: a 5-year single-center experience

The Author's describe the use of intrathecal Gd-enhanced MR cisternography for the definition of cerebrospinal fluid leaks in 51 patients. They were able to identify the site of leak in 43 of 51 patients (84%). Although the technique is not new, most of the previous articles are found in the neuroradiology and radiology literature. Thus, the value of this article is to further inform the neurosurgical readership regarding the technique. There have been reported complications with the administration of intrathecal GD, although it was reassuring that none have been reported with the patients studied here. This study does not compare CT cisternography in the same group of patients, but the reported sensitivity for leak detection using MR cisternography reported here compares favorably with previous reported CT cisternography data. CT scanning, however, provides complementary information, as it is easier to correlate site of leak with a bone defect.