Radionuclide Cisternogram

A radionuclide cisternogram is used to assess a number of neurological conditions by evaluating the circulation of cerebrospinal fluid.

How to Prepare

When you schedule your radionuclide cisternogram, you will be told whether the procedure will be performed on an inpatient or outpatient basis. If it is to be performed on an outpatient basis, please arrive at the time and location given to you. You can expect to go home the same day, approximately six hours after the cisternogram is completed.

Prior to undergoing this procedure, your CINN Outpatient Center nurse will arrange for you to have a blood test.

You must arrange for a friend or family member to drive you home, unless you are staying at the hospital overnight.

Bring a loose-fitting outfit with you to the hospital. Wearing comfortable clothes while returning home will minimize any discomfort you experience.

You may eat and drink as usual and remain active right up until the time of your appointment.

Do not take any aspirin or aspirin-containing products including Alka Seltzer, Anacin, Bufferin, and Empirin for one week prior to your appointment. Also, do not take Darvon, Naprosyn, Voltaren, Indocin or any products containing ibuprofen including Advil and Motrin for one week prior to your appointment. Ask your physician when you can resume taking any of these medications. You may take Tylenol and acetaminophen.

If you regularly take a blood-thinning medication, such as aspirin or Coumadin, notify your CINN physician. Your dosage may be adjusted in preparation for the radionuclide cisternogram.

Tell your CINN physician if you are pregnant or nursing, or if you have any allergies.

If you develop a cold, fever, or flu symptoms before your scheduled appointment, contact your CINN physician.

Tell your CINN physician or your Outpatient Center nurse in advance if you have a history of claustrophobia (fear of closed-in places). If you are claustrophobic, you will be given a prescription for a sedative prior to your appointment. Please be sure to take the medication as directed on the container.

What to Expect

Once you are settled in your room, you will be asked to disrobe and put on a hospital gown. Do not bring any jewelry or other valuables to the hospital the day of your procedure.

Your nurse will perform a physical exam, which will include taking your vital signs and conducting a brief neurological evaluation. An intravenous (IV) line may be placed in your hand or arm. A hospital transporter will then help you onto a cart and take you to the examination room.

You will be asked to lie on your side. Then the radiologist will begin the process of removing a small amount of your cerebrospinal fluid for laboratory analysis. He or she will use an antibacterial solution to cleanse the selected insertion site on your back or neck, then inject a local anesthetic to numb the area. You may feel a burning sensation for a few seconds when the anesthetic is injected. After the area is numb, the radiologist will insert another needle through your skin and into the fluid-filled space that surrounds your spinal cord. You will not feel any sharp pain, although you may feel as though someone is putting pressure on your back. The radiologist will then use the needle to withdraw a small amount of cerebrospinal fluid.

Next the radiologist will inject a small amount of radioactive substances called radionuclides through the needle into the fluid-filled space. You will not experience pain during this part of the procedure.

Afterward, a hospital transporter will help you onto a cart, take you back to your room, and help you into bed. You will remain flat in bed for the next six hours. When you need to empty your bladder, your nurse will assist you with a urinal or bedpan. You may return home six hours after your test, unless you are scheduled to stay overnight.

If you are undergoing the test as an outpatient, please have a family member or friend drive you home after you are discharged, and be sure to recline in the car as much as possible. After you return home, please continue on flat bed rest for 24 hours. While on bed rest, you may sit up to a 30 degree angle for meals and may get up to use the bathroom.

At intervals specified by your CINN physician, (typically at 24, 48, and sometimes 72 hours following the injection), you will return to the hospital for follow-up scans with a gamma camera. You will either remain on the cart or be asked to sit in a chair while a nuclear medicine technologist positions the camera. The technologist will take approximately four different "pictures" of your head and neck, a process that takes 30 to 60 minutes.

After each of the follow up scans you may return home and to your normal activities, unless you are remaining in the hospital between follow-up scans.

If you remain in the hospital between scans, you may drive yourself home after you are discharged.

You may experience side effects caused by the removal of some of your cerebrospinal fluid. The most common side effect is a headache that persists for several hours or up to several days. Symptoms that may accompany a headache include nausea, vomiting, dizziness, or tightness in the shoulders, base of the neck, or lower back. Drinking caffeinated beverages may be especially helpful in relieving a headache, as may lying down. You may take Tylenol; do not, however, take any aspirin-containing medications.

You will probably be able to resume your normal activities within 24 to 48 hours of your test. If, after this time, you are still experiencing a headache or any other symptoms, please call your CINN physician.

You might wonder whether the radionuclides you receive during this test will make your body radioactive. The answer is no: your body will not be radioactive for any amount of time, and you will not pose any risk to other people by being around them. Tell your physician, however, if you are pregnant or nursing. The test will not be performed in that case.

Additional Instructions

After your test drink plenty of fluids for the remainder of the day, unless otherwise instructed. This will help flush the radioactive substances from your system.