Diskogenic Dural Defect Is the Reason for the Ventral Location of the Epidural Spinal Fluid Collection Seen in Superficial Siderosis.

Abstract

Superficial siderosis (SS) of the nervous system is often due to a dural pathology. This review focuses on recent developments related to the management of this subgroup of patients with SS. The presence of an epidural ventral spinal fluid collection in patients with SS is a clue to the presence of a diskogenic dural defect. The location of the defect is ascertained by a dynamic CT myelogram, which involves placing the patient in a prone position with hips elevated. This permits gravity-assisted preferential ventral localization of the contrast and active scanning during contrast injection facilitates a precise delineation of the initial point of contrast extravasation which localizes the defect. Diskogenic dural defects are commonly the underlying etiology for SS in patients with a ventral spinal fluid collection. A dynamic CT myelogram facilitates detection and subsequent repair of these defects, which arrests the continued low-grade subarachnoid bleeding.