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Why human color vision cannot reliably detect cerebrospinal fluid xanthochromia.
Axel Petzold1, Geoffrey Keir, Ted L Sharpe
1The National Hospital for Neurology and Neurosurgery, Department of Neuroimmunology, Institute of Neurology, Queen Square, London, UK. a.petzold@ion.ucl.ac.uk
Stroke
|May 10, 2005
Summary
Visual assessment of cerebrospinal fluid (CSF) for xanthochromia is unreliable for diagnosing intracranial bleeds. Spectrophotometry offers a more accurate method for detecting bilirubin in CSF, replacing subjective visual analysis.
Area of Science:
- Clinical Chemistry
- Biomedical Diagnostics
Background:
- Cerebrospinal fluid (CSF) xanthochromia (yellowing) is commonly assessed visually to diagnose intracranial bleeds.
- Visual assessment is subjective and may lead to misdiagnosis.
Purpose of the Study:
- To evaluate the reliability of visual CSF xanthochromia assessment.
- To establish spectrophotometry as a superior diagnostic method for detecting bilirubin in CSF.
Main Methods:
- Colorimetric and spectrophotometric analysis of CSF samples.
- Quantification of bilirubin levels, including in cases of hemolysis.
Main Results:
- Established the physiological and colorimetric basis for visual assessment's inadequacy.
- Demonstrated spectrophotometry's capability to accurately detect bilirubin.
Conclusions:
- Visual assessment of CSF for xanthochromia should be abandoned.
- Spectrophotometry is the recommended analytical method for diagnosing intracranial bleeds via CSF analysis.