What causes Xanthochromia in CSF?

What causes Xanthochromia in CSF?

Xanthochromia is a yellow, orange, or pink discoloration of the CSF, most often caused by the lysis of RBCs resulting in hemoglobin breakdown to oxyhemoglobin, methemoglobin, and bilirubin. Discoloration begins after RBCs have been in spinal fluid for about two hours, and remains for two to four weeks.

How does Xanthochromia help in subarachnoid hemorrhage?

Xanthochromia is the presence of bilirubin in the CSF. This finding can be the only positive marker that a patient is suffering from an acute SAH. It is an important finding in distinguishing between traumatic tap and a SAH. Visual inspection of the CSF is the most common method of detection.

What does yellow spinal fluid mean?

Spinal fluid is normally clear and colorless. If it’s cloudy, yellow or pink in color, it might indicate abnormal bleeding. Spinal fluid that is green might indicate an infection or the presence of bilirubin.

What is a traumatic tap?

A “traumatic tap” occurs if the needle inadvertently has entered an epidural vein during insertion. A yellowish tinge to the CSF fluid is called xanthochromia. Xanthochromia is usually caused by red blood cell degeneration in the CSF as would be seen in subarachnoid hemorrhage (SAH).

What is the most common cause of xanthochromia?

The presence of bilirubin in CSF is the main cause of xanthochromia associated with high spinal fluid protein content, usually found above levels of 150 mg/dl.

How long does it take for xanthochromia to develop?

Therefore, xanthochromic CSF at the time of LP indicates SAH; however, xanthochromia can take as long as 12 hours to develop (19), and delaying an LP for that long after ictus to ensure its appearance may be unacceptable.

How long does xanthochromia CSF last?

Xanthochromia can persist for as long as several weeks after a subarachnoid hemorrhage (SAH). Thus, it has greater diagnostic sensitivity than computed tomography (CT) of the head without contrast, especially if the SAH occurred more than 3-4 days before presentation.

How can CSF be corrected for RBC?

For every 500 (or 1,000) RBCs in the CSF, you can have 1 WBC in the CSF. You can simply subtract this “allowable” number of WBCs from the actual number in the CSF analysis. Now you have a “corrected” WBC count that you can interpret.

Why is nimodipine used for subarachnoid hemorrhage?

Nimodipine is used to decrease problems due to a certain type of bleeding in the brain (subarachnoid hemorrhage-SAH). Nimodipine is called a calcium channel blocker. The body naturally responds to bleeding by narrowing the blood vessel to slow blood flow.

What is xanthochromia and what does it indicate?

By definition, xanthochromia is the yellow discoloration indicating the presence of bilirubin in the cerebrospinal fluid (CSF) and is used by some to differentiate in vivo hemorrhage from a traumatic LP.

What is CSF xanthochromia?

By definition, xanthochromia is the yellow discoloration indicating the presence of bilirubin in the cerebrospinal fluid (CSF) and is used by some to differentiate in vivo hemorrhage from a traumatic LP. In contrast to CT, CSF xanthochromia is present in all patients up to 2 weeks postictus and is still present in 70% of patients at 3 weeks .

Can the xanthochromia test overcome the confusion in diagnosing subarachnoid hemorrhage?

In all our positive results to date, the clinical follow up has confirmed positive xanthochromia. In conclusion, this test is simple, inexpensive, can easily be interpreted, and thereby overcomes the confusion in diagnosing subarachnoid hemorrhage ( 6 ) ( 7 ) ( 8 ).

What is the pathophysiology and management of unconjugated hyperbilirubinemia?

In newborns, unconjugated hyperbilirubinemia is very common, and increased bilirubin (UCB) levels can cause life-threatening kernicterus. This activity describes the pathophysiology and management of unconjugated hyperbilirubinemia. It also highlights the importance of teamwork in the management of patients with this disease.