MRI Assessment for CSF Leakage Diagnosis

The primary driver for MRI assessment in diagnosing CSF leakage is to confirm low CSF pressure or volume state through investigating brain imaging with contrast. Signs of parenchymal sagging, posterior fossa sagging, dual congestion, dual thickening, avid enhancement, and venous congestion are key indicators. Analyzing CSF distribution in the epidural space in the spine helps determine the type of leak, crucial for treatment, prognosis, and further management. A ventral longitudinally extensive CSF collection suggests a type 1 leak from a dura rent, while fluid around nerve roots indicates a type 2 leak. Absence of a collection with intracranial hypotension signs points towards a CSF venous fistula.