© 2004 BMJ Publishing Group Ltd
EDITORIAL COMMENTARY
CSF analysis in subarachnoid haemorrhage
Recommendations for CSF analysis in subarachnoid haemorrhage
Correspondence to:
Correspondence to:
Dr R Beetham
Department of Clinical Biochemistry, North Bristol NHS Trust, Frenchay Hospital, Bristol BS16 1LE, UK; Robert.Beetham@north-bristol.swest.nhs.uk
Spectrophotometry of CSF involving bilirubin quantitation is the recommended method of analysis
| The first 150 words of the full text of this article appear below. |
In this journal in the late 1980s, two papers presented contrasting advice about the appropriate investigation of cerebrospinal fluid (CSF) in suspected subarachnoid haemorrhage when computed tomography (CT) of the head revealed no evidence of blood. The first concluded that it was the detection of red blood cells that was important in supporting a decision to proceed to cerebral angiography and not that of the red cell breakdown products, oxyhaemoglobin and bilirubin.1 This was a conclusion based on the use of visual inspection to detect the colour (xanthochromia) imparted by oxyhaemoglobin and bilirubin. The second, based on a series of 111 patients in whom blood was found on CT, concluded that it was the presence of oxyhaemoglobin and bilirubin, as detected spectrophotometrically, that was important.2 An editorial in The Lancet picked on the difference in examination principle (visual inspection versus spectrophotometry) as being fundamental to
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