Rapid transit of tracer to the kidneys and urinary bladder in radionuclide cisternography: A sign of CSF leak

A 20-year-old woman complained of postural headache after severe emesis. Lumbar puncture showed no abnormality except for low cerebrospinal fluid pressure. Radionuclide cisternography at 4-hour and 24-hours showed no tracer in the basal cisterns or cerebral convexities. The 4-hour image showed tracer in the renal area, and at 24 hours there was tracer in the urinary bladder. There was no direct evidence of CSF leak. ACTmyelogram showed a CSF leak near the third and fourth lumbar nerve roots.