Let's learn about the Cisternogram Scan test.

Your doctor may have prescribed you a 'Cisternogram Scan'. You may have been a little scared when you heard the name, right? "What is this strangely named scan? Why is it being done? Is it difficult?" You may be wondering. Don't worry. It's normal to have questions like these. Today, we'll talk about this test in a very simple way, in a way that you can understand, as if you were talking to a close friend.

What exactly is a Cisternogram Scan?

Before we understand this, let's learn a little about something very important in our body. Imagine that our brain and spinal cord are like precious glass objects. To protect these precious objects, there is a liquid covering, a cushion, around them. In medicine, we call this 'cerebrospinal fluid' or Cerebrospinal Fluid (CSF) . This CSF fluid performs several very important functions for our body.

• Provides nourishment: This fluid provides nourishment to our brain and the spinal cord that runs along the spine.
• Helps with function: This is essential for the healthy functioning of our Central Nervous System (CNS).
• Removes toxins: Helps to remove and cleanse unwanted toxins that accumulate in the surrounding tissues.
• Provides protection: When we run, jump, or hit our head somewhere, it acts like a cushion that protects the brain from shock.

So, what this cisternogram scan does is check whether the CSF fluid in your body is flowing properly, whether there is a blockage somewhere, or whether there is a leak somewhere.

This is a type of test called nuclear medicine imaging . This means that a small amount of radioactive material is injected into your spine. Don't worry, it won't hurt you. This material allows the path of CSF fluid to be seen clearly, in color, on the scan images.

In what cases is this test necessary?

Simply put, this test is ordered if your doctor suspects that your CSF fluid is leaking from somewhere (CSF leak) or that there is too much of it inside your brain (CSF buildup). Both conditions can cause similar symptoms.

Check the table below to see if you have any of these symptoms.

If you have these symptoms, your doctor may recommend this test to find the exact cause.

How should I prepare before the test?

Most of the time, this doesn't require any special preparation. However, it is very important to follow the instructions given by your doctor or hospital exactly.

Before the test, be sure to inform your doctor about these things:

• Allergies: If you have any allergies to local anesthetics or other anesthesia medications, be sure to mention it.
• Pregnancy: If you may be pregnant or are breastfeeding, it is very important to tell your doctor beforehand, as this test uses a radioactive substance.
• Medications you are taking: Tell your doctor about all medications, vitamins, herbal remedies, and supplements you are taking. Some medications, such as blood thinners (such as aspirin and warfarin) , may need to be stopped a few days before the test.
• Practical advice: You may find it difficult to drive after the test. Therefore, it is a good idea to take someone with you. Also, since the test takes place over several days, plan your activities accordingly.

What happens during the test?

This test consists of two main steps: first, inserting a needle into the spine, and then taking scan images.

First step: Lumbar puncture

Even though I was scared when I heard this, this is done very carefully by a very experienced doctor.

1. First, you will be made to lie on a table, either face down or on your side with your knees drawn up to your chest.

2. Then, the injection site in your back will be cleaned thoroughly and a local anesthetic will be injected into the area. This will numb the area. Some people may also be given a small sedative to keep them calm.

3. Now the doctor will very carefully insert a thin needle between two bones in your lower spine. At this time, a real-time X-ray technique called fluoroscopy will be used to make sure the needle is in the right place.

4. Once the needle is in the correct position, the previously mentioned radioactive substance is slowly injected into your CSF fluid through the needle.

5. Then the needle is carefully removed and a small plaster is applied to the area.

Step Two: Taking Scanned Images

1. After the needle is inserted, you will be asked to lie still for about an hour. This is to allow the radioactive material to travel through the CSF fluid.

2. Your first scan will take between one and six hours. You will lie down under a scanner with a special gamma camera. Sometimes a CT scan or MRI may be done at the same time.

3. You can go home after the first scan. However, you will need to come back for another scan after 24 hours , as it takes about a day for the radioactive material to reach all the cavities in the brain.

4. Some people may need to have a scan after 48 or 72 hours . This will be determined by your doctor.

Does this hurt? Are there any side effects?

• Pain: You may feel a slight stinging sensation when the numbing medicine is injected. You may feel a pinch when the needle is inserted into your back, but it should not be too painful . If you feel any pain, tell the doctor or nurse right away. The scan itself does not hurt at all.
• Side effects: The most common side effects are mild pain and a headache at the injection site. Sometimes a small amount of CSF can leak from the area where the needle was inserted into the spine. This can cause a slight decrease in pressure in the brain and cause a severe headache. This usually resolves on its own within a few hours or two to three days. Drinking plenty of fluids and resting can help.

What are the risks of a cisternogram test?

Serious complications from this test are very rare . However, as with any medical test, there are some small risks, so we should be aware of them.

• Allergic reactions to radioactive material or anesthetics.
• Bleeding in the brain or spinal cord (hemorrhage) .
• Infection at the site of the needle insertion.
• Nerve damage is very rare.
• Brainstem herniation (this is a very rare condition. It is a condition where brain tissue is pushed out due to pressure inside the skull).

Even though a radioactive substance is used, you will be exposed to a very small dose of radiation . Don't be unnecessarily afraid of it.

What do the results say?

You may receive your results (report) within a few days or a week after your last scan. When you receive it, your doctor will explain what it means to you.

• Normal Results: If your report comes back normal, it means that your CSF fluid is flowing normally around your brain and spinal cord without any obstructions or leaks.
• Abnormal Results: If the results are abnormal, it may indicate one or more of the following conditions.

Cisternogram, Cisternogram Scan, CSF leak, Cerebral fluid, Water in the spinal cord, Lumbar Puncture, Hydrocephalus, Scan