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Postural Headache and Cerebrospinal Fluid Leak: Believing Is Seeing



A 33-year-old woman developed persistent postural headache following epidural anesthesia (L2-L3 level). Iohexol myelography (L5-S1 puncture) demonstrated no epidural extravasation of contrast material (Figure A), but subsequent computed tomography (CT) axial images (B, C) revealed leakage of dye through the needle track of the L5-S1 puncture (arrows). No leakage of contrast medium was found at the site of the L2-L3 epidural puncture.