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Medical Imaging

Nuclear Medicine > Exams & Procedures > CSF Leak Scan (Rhinorrhea/Ottorrea)

This test will assess normal and abnormal pathways of cerebral spinal fluid drainage (the fluid found in the spinal cord and around your brain). Specifically, this test determines if there is a leakage of the spinal fluid through your nose or ears.

The physician will insert pledgets (small pieces of medical cotton) in your nose and ears followed by the injection of a radioactive tracer into the cerebral spinal fluid. The injection is given as a lumbar puncture (insertion of the needle into the lower back) by a highly trained doctor under X-ray guidance. You will be kept on a stretcher for at least four hours following the injection. This helps to eliminate the possibility of developing a headache from the injection. Pictures will be taken in the nuclear medicine department to follow the natural flow of the tracer in the cerebral spinal fluid. The pledgets will be removed at the end of the first day. A blood sample will be taken at this time to see if the spinal fluid has leaked into the bloodstream. You will return the next day for 24-hour delayed pictures.


  • Bring a list of all medications and supplements you take. This includes vitamins, herbal remedies, and holistic medications.
  • Do not bring children or pregnant women with you to the department. We do not want to expose them to unnecessary radiation.
  • Any of these procedures is subject to change according to the nuclear medicine physician. The duration of the tests is a rough estimate. Please be aware that the time may be lengthened if a scan has to be repeated, if emergency cases are brought to the department or due to unforeseen circumstances.
  • The test takes about six hours plus a delayed picture the next morning. It is recommended that you bring lunch.

About the Procedure

Day one - six hours with breaks in between.
Day two - 30 minutes.

  • You will check in with the Department of Nuclear Medicine.
  • You will check in with the ENT (ear, nose and throat) Department and a physician will insert pledgets in your nose and ear.
  • You will check in with the X-ray department.
  • You will be taken to change into hospital gowns in the X-ray department.
  • An X-ray technologist will explain the lumbar puncture procedure to you.
  • A doctor will prepare the injection site, give and anesthetic to that site, and make the injection of the tracer under X-ray guidance.
  • After the lumbar puncture you will be brought to the Department of Nuclear Medicine on a stretcher.
  • Pictures of your back and head will be taken two and five hours after the injection.
  • After the five hour pictures the pledgets will be removed and a blood sample will be taken.
  • You will return to nuclear medicine the next morning for 24-hour delayed pictures.

Possible Adverse Effects

You may get a headache from the lumbar puncture injection. The chance of getting a headache is minimized by lying down for the duration of the test.