Patient-Facing Neuroradiology Consultations Advocated for Spinal CSF Leak Diagnosis

When suspected spinal CSF leak imaging is negative or discordant, neuroradiologists should consult directly with patients to reconcile findings, direct next steps, and reduce diagnostic delays—stepping out of the reading room for better care.

• State of Practice review synthesizing imaging evidence and a subspecialized neuroradiology practice perspective; proposes a direct patient-consultation model.
• Highlights that normal brain MRI and non-diagnostic myelography often reflect test limitations, and classic orthostatic headache is an imperfect entry criterion, contributing to diagnostic delays.
• Limitation: single-practice perspective without prospective validation of the consultation model.

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