Can Cerebrospinal Fluid Uric Acid Levels Differentiate Intraventricular Hemorrhage from Traumatic Tap?

Abstract

Objective: To measure blood and cerebrospinal fluid (CSF) uric acid (UA) levels of neonates with intraventricular hemorrhage (IVH), and to examine whether or not UA can be used to differentiate traumatic tap from IVH. Material and Methods: The control group (n = 19, group I) consisted of neonates presenting with signs requiring analysis of CSF but whose CSF indices proved to be normal. Traumatic taps (n = 15, group II) were mimicked by adding 2 drops of homologous blood to normal CSF samples. The IVH group (n = 21, group III) consisted of neonates who had been diagnosed by cranial ultrasonography or computed tomography scans. Data are presented as median (range). Results: There was no significant difference between groups with respect to serum UA levels. While no significant difference was observed between CSF UA levels of the control [0.6 (0.1–1.8) mg/dl] and traumatic tap group [0.5 (0.3–1.1) mg/dl], the IVH group [1.6 (0.7–6.9) mg/dl] was found to have significantly higher CSF UA levels than groups I and II. Furthermore, although there were significant correlations between serum and CSF UA levels in the control and traumatic tap groups, no correlation was observed in the IVH group. Conclusion: CSF UA levels are increased in neonates with IVH and they may be used to differentiate a real hemorrhage from a traumatic tap.

Biomarkers of Brain Injury in the Premature Infant

“…Perlman and Risser (1998) reported elevated concentrations of UA (during first 24 h) in premature infants that developed IVH and PVL. In support of these findings, Aliefendioglu et al (2006) found that high UA concentrations in CSF were associated with a higher risk of IVH. However, other study of low birth weight infants did not find association between elevated UA in serum and IVH (Sysyn and Rozycki, 2003).…”

Free Radicals and Neonatal Brain Injury: From Underlying Pathophysiology to Antioxidant Treatment Perspectives

“…On the other hand, the relationship between plasma UA and the development of severe IVH or PVL in preterm neonates is controversial. Pearlman et al reported increased UA concentrations on the first postnatal day in ELBW infants developing severe IVH/PVL, even after adjustment for GA and other relevant clinical variables [ 105 ]; subsequent data from a larger sample of preterm neonates with similar brain injury, however, failed to confirm this association [ 106 , 107 ]. Finally, significantly higher UA levels were observed in the CSF of preterm neonates with IVH grade 2 to 4 [ 107 ].…”