INTERVENTIONAL RADIOLOGY DISCHARGE INSTRUCTIONS

at The University of Kansas Hospital, Kansas City, Kansas 

CISTERNOGRAM  

A cisternogram is performed to detect problems with spinal fluid circulation and cerebrospinal fluid (CSF) leaks. It is a study that can be completed in 3 different ways: either using CT, MRI, or nuclear medicine scans. A radionuclide cisternogram is a procedure which involves injecting a radionuclide into the spinal canal to determine if there is abnormal CSF flow within the brain and/or spinal canal. It may also evaluate a suspected leak (also known as a CSF fistula) from the CSF cavity into the nasal cavity. You will be scanned in Nuclear Medicine after the injection, and again in 48 hours. For a CT or MRI cisternogram, either CT or MRI contrast will be injected via lumbar puncture.  For these types of cisternogram, you will not have to return after 48 hours for an additional scan.

POST-PROCEDURE PAIN:

  • Pain control following your procedure is a priority for both you and your Physicians.
  • Some soreness or tenderness at the site is to be expected for several days. We recommend taking over the counter analgesics to help relieve this pain.
  • Alternative methods for pain relief include but not limited to heat or cold compress, relaxation techniques, rest, and changing of positions. 
  • If pain continues after 5-7 days or you have severe pain not relieved by medication, please contact us as directed below.  

POST-PROCEDURE ACTIVITY:

  • A responsible adult must drive you home.  You should not drive after the cisternogram until the following morning.
  • If you receive sedation, narcotic pain medication or anesthesia for the procedure, you should not drive or operate heavy machinery or do anything that requires concentration for at least 24 hours after procedure completion.
  • It is recommended that a responsible adult be with you until morning.
  • You should rest for 6-8 hours after the procedure with your head at a 30-45⁰ angle (1-2 pillows).
  • If you develop a “spinal” headache, lie flat for 24 hours.  A “spinal” headache is caused by a CSF leak; a typical symptom is when your headache is worse when you are up that improves when lying flat.
  • You should rest today and avoid lifting or straining for 24 hours.  You may resume normal activity in 24 hours, only limited by residual pain.  Some residual pain is to be expected for a couple of days post procedure. 

POST-PROCEDURE SITE CARE:

  • You will have a small bandage over the procedure site.  Keep this dry.
  • You may remove it in 24 hours.
  • You may shower in 24 hours, after removing the bandage.
  • Do not submerge the procedure site for 1 week (no bathtub, swimming, hot tub, etc.)
  • Do not use ointments, creams or powders on the puncture site.
  • Be sure your hands are clean when touching near the site.  

DIET/MEDICATIONS:

  • You may resume your previous diet after the procedure.
  • If you receive sedation or narcotic pain medications, avoid any foods or beverages containing alcohol for at least 24 hours after the procedure.
  • Please see the Medication Reconciliation sheet for instructions regarding resuming your home medications.
  • Keep well hydrated; you are encouraged to drink plenty of caffeinated fluids as this can help to prevent a “spinal” headache.  

CALL THE DOCTOR IF:

  • You develop a severe headache or new onset neck stiffness. 
  • Bright red blood soaks the bandage.
  • You have pain not relieved by medication.  Some soreness at the site is to be expected.
  • You have signs of infection such as: fever greater than 101F, chills, redness, warmth, swelling, drainage or pus from the puncture site.  

For any of the above symptoms or for problems or concerns related to the procedure, call 913-574-4846 Monday-Friday from 7-5p.  After-hours and weekends, please call 913-588-5000 and ask for the Interventional Radiology Resident on-call.

You or your caregiver should call 911 for any severe symptoms such as excessive bleeding, severe dizziness, trouble breathing or loss of consciousness.