Spectrophotometry of cerebrospinal fluid for xanthochromia is a sensitive and specific test for subarachnoid bleeding but adds little to computed tomography

Wulff, Anders Berg; Højgaard, Joan; Hilsted, Linda

doi:10.1080/00365513.2020.1846208

Cited by 1 publication

(3 citation statements)

References 22 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…ing SAH is known to be sensitive [5,24]. We found a sensitivity of 100% and a negative predictive value of 100%.…”

Section: Spectrophotometric Detection Of Xanthochromia For Diagnos-mentioning

confidence: 46%

“…Spectrophotometric detection of xanthochromia for diagnosing SAH is known to be sensitive [ 5 , 24 ]. We found a sensitivity of 100% and a negative predictive value of 100%.…”

Section: Discussionmentioning

confidence: 99%

“…The original spectrophotometry reports are obtained from the Department of Multidisciplinary Medicine and Medical Biochemistry database and manually reviewed. The reports are coded positive or negative for xanthochromia, and the positive reports are further recoded into true‐positive or equivocal as done by others [ 16 , 19 , 24 , 25 ]. They are coded positive if bilirubin alone or both bilirubin and oxyhemoglobin are present, and equivocal if oxyhemoglobin is present in sufficient amount to impair the ability to detect bilirubin or by increased bilirubin accompanying the increased CSF‐protein or other source of CSF blood.…”

Section: Methodsmentioning

confidence: 99%

See 2 more Smart Citations

Diagnostic workup of acute headache and subarachnoid hemorrhage in a Norwegian population: An observational study

Aaseth,

Dhami,

Kravdal

et al. 2024

Euro J of Neurology

View full text Add to dashboard Cite

BackgroundAcute headache may be the primary symptom of subarachnoid hemorrhage (SAH). Recent guidelines suggest that non‐contrast computed tomography (CT) is adequate to exclude aneurysmal SAH if performed within 6 h after symptom onset. However, most studies of acute headache including CT, lumbar puncture and SAH are multicenter studies from referral hospitals with highly selected patient populations. The main purpose of this study was to describe the diagnostic properties of head CT and cerebrospinal fluid (CSF) spectrophotometry for detecting SAH in an unselected primary hospital population with acute headache.MethodsA retrospective cross‐sectional study conducted at a large primary hospital serving roughly 10% of the Norwegian population. Diagnostic workup from consecutive patients evaluated for acute headache in 2009–2020 were collected. All CSF‐spectrophotometry reports were standardized and the same CT scanner was used during the study.ResultsA total of 3227 patients were included. Median age was 45 years and 63% were women. In total, 170 (5.3% of all acute headache patients) had SAH. Of 3071 CT‐negative patients, 2852 (93%) underwent lumbar puncture. Of the CSF reports, 2796 (98%) were negative for xanthochromia. Overall, the rate for detection of aneurysmal SAH by positive xanthochromia was 9 in 2852 cases (3‰). The miss rate for the detection of an aneurysmal SAH with a CT scan within 6 h was 0 and within 12 h 1 in 2852 cases (0.3‰).ConclusionIn acute headache, a CT scan taken within 6 h is practically 100% sensitive for detecting any SAH.

show abstract

“…ing SAH is known to be sensitive [5,24]. We found a sensitivity of 100% and a negative predictive value of 100%.…”

Section: Spectrophotometric Detection Of Xanthochromia For Diagnos-mentioning

confidence: 46%

“…Spectrophotometric detection of xanthochromia for diagnosing SAH is known to be sensitive [ 5 , 24 ]. We found a sensitivity of 100% and a negative predictive value of 100%.…”

Section: Discussionmentioning

confidence: 99%