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Improvement by cerebrospinal fluid spectrophotometry of diagnosis in acute intracerebral hemorrhages not revealed by visual and microscopic classical examination of cerebrospinal fluid



Improvement by cerebrospinal fluid spectrophotometry of diagnosis in acute intracerebral hemorrhages not revealed by visual and microscopic classical examination of cerebrospinal fluid



Revue Roumaine de Medecine Neurologie et Psychiatrie 23(2): 111-118



Computerized axial tomography is not available for the vast majority of stroke patients worldwide. Therefore, the investigation of cerebrospinal fluid (CSF), collected by rachidian puncture (RP), is still very important. For diagnosis ascertainment of acute intracerebral hemorrhage and rejection of the diagnosis of infarction we compared the data of CSF spectrophotometry with those of classical CSF visual inspection and examination by light-microscope. Spectrophotometrical detection in CSF of hemoglobin derivates is swiftly possible, for detection of an absorbance over 0.04 at 415 nm wavelength, the principal maximum-absorbance point for oxyhemoglobin is characteristic and ascertains blood presence, making unnecessary the reading of the whole absorbance-curve. CSF spectrophotometry improves the diagnosis in 18% of patients in whom the classical CSF examination was dubious for diagnosis of hemorrhage. In 4% of patients a negative spectrophotometry overrules the suspicion of hemorrhage showing that the erythrocytes found microscopically result from a traumatic RP. In 10% of patients with uncertain xanthochromy and rare erythrocytes at microscopy, spectrophotometry ascertains the presence of hemoglobin derivates, as well as in other 4% of patients, in whom the classical CSF examination was entirely negative. In 6% of patients, in whom both examinations were negative in the CSF collected early, within a few hours from stroke onset, a second CSF spectrophotometry, performed 3-5 days later, revealed hemoglobin derivates, while the classical CSF investigation remained negative. The latter finding suggests that a delayed (by 3-5 days) RP enhances at maximum the probability to detect spectrophotometrically the presence of blood in CSF.

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Improvement by CSF spectrophotometry of diagnosis in acute intracerebral hemorrhages not revealed by visual and microscopical classical examination of CSF. Neurologie et Psychiatrie 23(2): 111-117, 1985

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