alexa Christmas Tree Sign: Paraspinal Cerebrospinal Leak on 99mtc-DTPA Radionuclide Cisternography
ISSN: 2155-9619

Journal of Nuclear Medicine & Radiation Therapy
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Case Report

Christmas Tree Sign: Paraspinal Cerebrospinal Leak on 99mtc-DTPA Radionuclide Cisternography

Nosheen Fatima1, Maseeh uz Zaman2*, Atta ul Aleem Bhatti3, Imtiazul Haque Khurshaidi1, Ali Jawaid Siddiqui1 and Aitadal Moin Shaikh1

1Department of Nuclear Medicine, Dr. Ziauddin Medical University Hospital, Karachi, Pakistan

2Nuclear Medicine Section, Department of Radiology, Aga Khan University Hospital, Karachi, Pakistan

3Departmentof Neurosurgery, Dr. Ziauddin Medical University Hospital, Karachi, Pakistan

*Corresponding Author:
Maseeh uz Zaman
Associate Professor and Section Head Nuclear Medicine
Department of Radiology
Aga Khan University Hospital (AKUH), Karachi, Pakistan
E-mail: [email protected]

Received date: June 22, 2013; Accepted date: August 08, 2013; Published date: August 12, 2013

Citation: Fatima N, Zaman Mu, Aleem Bhatti Au, Khurshaidi IH, Siddiqui AJ, et al. (2013) Christmas Tree Sign: Paraspinal Cerebrospinal Leak on 99mtc-DTPA Radionuclide Cisternography. J Nucl Med Radiat Ther 4:160. doi:10.4172/2155-9619.1000160

Copyright: © 2013 Fatima N, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.



Radionuclide cisternography (RC) is an underutilized but sensitive modality used to differentiate between normal pressure and non-communicating hydrocephalus and can also detect cerebrospinal fluid (CSF) leakage. We present a case of intracranial tuberculous with severe headache and hydrocephalus. RC was performed with Tc-99m labeled DTPA showing communicating hydrocephalus with characteristics Christmas tree sign and early appearance of renal activity due to spinal CSF leak into systemic circulation. This patient responded well to ventriculo-peritoneal shunt (VP shunt).

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