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Postmortem cerebrospinal fluid pleocytosis: a marker of inflammation or postmortem artifact?

James A Morris1, Linda M Harrison, David R Telford

  • 1University Hospitals of Morecambe Bay NHS Foundation Trust, Royal Lancaster Infirmary, Ashton Road, Lancaster, LA1 4RP, UK.

International Journal of Pediatrics
|April 21, 2012
PubMed

Insights

Postmortem cerebrospinal fluid (CSF) pleocytosis, an increase in white blood cells, may indicate inflammation. This reassessment reviews CSF changes after death, particularly in pediatric cases like sudden infant death syndrome (SIDS).

Area of Science:

  • Neurology
  • Forensic Pathology
  • Immunology

Background:

  • Cerebrospinal fluid (CSF) analysis is crucial in diagnosing neurological conditions.
  • Understanding postmortem changes in CSF is vital for forensic investigations.
  • Previous interpretations of postmortem CSF pleocytosis require reevaluation in light of current knowledge.

Purpose of the Study:

  • To reassess the significance of postmortem cerebrospinal fluid (CSF) pleocytosis.
  • To review existing literature on CSF changes after death.
  • To analyze CSF findings considering modern perspectives on bacterial isolates.

Main Methods:

  • Systematic review of published articles on postmortem CSF changes.
  • Reanalysis of data in the context of contemporary understanding of bacterial postmortem findings.
  • Evaluation of theoretical and experimental evidence regarding the postmortem blood-brain barrier.

Main Results:

  • The blood-brain barrier remains intact for several hours postmortem, limiting cell and protein movement.
  • Mononuclear cell counts in CSF increase within 24 hours postmortem, likely due to leptomeningeal cell detachment.
  • Elevated lymphocyte counts in pediatric deaths, including sudden infant death syndrome (SIDS), may signify inflammation.

Conclusions:

  • Postmortem CSF pleocytosis, particularly lymphocyte increases, warrants careful interpretation.
  • The findings suggest that elevated lymphocyte counts in postmortem CSF could serve as an inflammatory marker.
  • Further research is needed to fully elucidate the implications of postmortem CSF pleocytosis in various death scenarios.

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