Xanthochromia in subarachroid haemorrhage.

Mendelow, A. D.; Cartlidge, Neill E. F.

doi:10.1136/jnnp.53.3.270-a

Cited by 9 publications

(5 citation statements)

References 7 publications

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“…No entanto, Page et al 30 demonstraram que todos os indivíduos que apresentavam xantocromia visível tinham diagnóstico de hemorragia. A espectrofotometria tem grande utilidade nos casos sem a visualização de xantocromia 27 . Esses casos não foram incluídos neste estudo.…”

Section: Discussionunclassified

Fibrinolytic and factor XIII activity in subarachnoid hemorrhage

Pliego

Muchnik²

1997

Arq. Neuro-Psiquiatr.

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diagnóstico definitivo realizado por exame de líquido cefalorraquiano(LCR). Desses, 20 casos foram submetidos a angiografia cerebral. Estabeleceu-se a classificação clínica de Hunt & Hess. Os principais achados neste estudo foram:1) um terço dos pacientes apresentou intervalo de tempo entre o ictus e a realização da CT e do LCR entre 24 e 48 horas, período de maior sensiblidade da CT; 2) dos pacientes estudados com angiografia cerebral, 55% tiveram o diagnóstico de aneurisma com predomínio no território de carótida e cerebral anterior; 3) o grau clínico dominante foi Hunt & Hess I e II. Todos os achados encontrados demonstraram a necessidade da realização de LCR em suspeita de HSA sem sinais de sangramento na CT.PALAVRAS-CHAVE: hemorragia subaracnoídea, líquido cefalorraquiano, tomografia computadorizada. Hemorragia subaracnoídea (HSA) de origem não traumática é ocorrência grave e não rara, que a cada ano acomete aproximadamente 30.000 americanos 4 . Apesar dos avanços nas técnicas diagnosticas, cirúrgicas e aportes perioperatórios, a mortalidade permanece em torno de 25% com morbidade ao redor de 50%. Em estudos de epidemiologia, 25% dos pacientes morrem nas primeiras 24 horas após a HSA; 50% morrem no período de três meses e 64% de todas as mortes ocorrem na primeira semana 9 . A HSA pode ser secundária a ruptura de um ou mais aneurismas 1,2 ; pode ser espontânea (causa desconhecida), cuja incidência, na maioria dos estudos, é de 20 % 3,11 , podendo ter associação com fatores de risco como hipertensão arterial sistêmica, tabagismo e uso crônico do álcool 4 ; a HSA também pode ser de origem traumática. Em 1924, Charles Symonds estabeleceu a retirada do líquido cefalorraquiano (LCR) através de punção lombar, como procedimento útil para o diagnóstico de HSA. Desde então, por muitos anos, o exame de LCR foi o melhor método para se confirmar diagnóstico de pacientes que apresentavam sinais e sintomas de HSA 2fi -37 . Muitos desses pacientes acabavam evoluindo com complicações da punção lombar hoje bem conhecidas 13 ,

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Section: Discussionunclassified

Fibrinolytic and factor XIII activity in subarachnoid hemorrhage

Pliego

Muchnik²

1997

Arq. Neuro-Psiquiatr.

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“…Detection of xanthochromia by visual inspection of CSF supernatant is less sensitive than spectrophotometric assessment using a wavelength spectrum which includes oxyhaemoglobin, methaemoglobin and bilirubin 69,73,75,76 . Visual inspection is commonly used but may not detect up to 50% of xanthochromia 77 .…”

Section: Csf Interpretationmentioning

confidence: 99%

“…6,57,66,73,74 Detection of xanthochromia by visual inspection of CSF supernatant is less sensitive than spectrophotometric assessment using a wavelength spectrum which includes oxyhaemoglobin, methaemoglobin and bilirubin. 69,73,75,76 Visual inspection is commonly used but may not detect up to 50% of xanthochromia. 77 Xanthochromia does not absolutely exclude a traumatic tap because extremely bloody taps (> 12,000 RBC/mL) can cause xanthochromia within 30 min and repeat LP done several hours after a traumatic tap will also demonstrate xanthochromia.…”

Section: Xanthochromiamentioning

confidence: 99%

Perils and pitfalls of lumbar puncture in the emergency department

Cuthbert

2001

Emergency Medicine

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Lumbar Puncture is a procedure commonly performed in the emergency department. It provides important diagnostic information but has a significant number of limitations and complications. This article reviews the role of lumbar puncture in the emergency department based on an extensive review of the current literature, focusing on the recognized contraindications and complications of the procedure and how they can be minimized. The interpretation of diagnostic tests performed on cerebrospinal fluid is also examined, highlighting those tests most commonly ordered from the emergency department.

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“…In patients with suspected subarachnoid haemorrhage (SAH), the identi®cation of free oxyhaemoglobin and/or bilirubin in cerebro-spinal¯uid (CSF) is a valuable adjunct to diagnosis, particularly when computed tomography (CT) or magnetic resonance imaging give equivocal results. Although visual examination of CSF appears to be the most common approach used within the UK, 1 there is now general acceptance that spectrophotometric examination of CSF is the method of choice, 2,3 particularly as it is more sensitive than the eye for the detection of oxy-and methaemoglobin. 4±6 To avoid false-positive results for oxyhaemoglobin, it is important to avoid any in vitro haemolysis of red cells that may contaminate the CSF (e.g.…”

Section: Introductionmentioning

confidence: 99%

“…Although visual examination of CSF appears to be the most common approach used within the UK, 1 there is now general acceptance that spectrophotometric examination of CSF is the method of choice, 2,3 particularly as it is more sensitive than the eye for the detection of oxy-and methaemoglobin.…”

Section: Introductionmentioning

confidence: 99%

Interference in spectrophotometric analysis of cerebrospinal fluid by haemolysis induced by transport through a pneumatic tube system

Wenham

Hanson²,

Ashby³

2001

Ann Clin Biochem

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The hypothesis that sending blood-stained cerebrospinal¯uid (CSF) through a pneumatic tube causes in vitro haemolysis has been tested. Spectrophotometric scanning of CSF supernatants demonstrated a signi®cantly greater absorbance at 415 nm in those CSF samples that had been sent through the tube system compared to those that had not (P=0´0034). It is concluded that passage of blood-stained CSF down a pneumatic tube system causes in vitro haemolysis, accompanied by the release of oxyhaemoglobin from the lysed cells into the surrounding CSF. In view of this observation, it is recommended that CSF samples requiring spectrophotometric analysis, as part of the investigation of subarachnoid haemorrhage, should not be transported via a pneumatic tube system.

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Xanthochromia in subarachroid haemorrhage.

Cited by 9 publications

References 7 publications

Fibrinolytic and factor XIII activity in subarachnoid hemorrhage

Fibrinolytic and factor XIII activity in subarachnoid hemorrhage

Perils and pitfalls of lumbar puncture in the emergency department

Interference in spectrophotometric analysis of cerebrospinal fluid by haemolysis induced by transport through a pneumatic tube system

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