Cerebrospinal fluid cellular response in uncomplicated acute ischemic stroke

Area of Science:

• Neurology
• Neuroscience
• Stroke Research

Background:

• Cerebrospinal fluid (CSF) cellular response in acute ischemic stroke (AIS) lacks conclusive information.
• Previous studies have yielded inconsistent findings regarding CSF cell counts in AIS patients.

Purpose of the Study:

• To investigate the characteristics and diagnostic value of CSF cellular response in patients with uncomplicated AIS.
• To determine the prevalence and significance of CSF pleocytosis in the acute phase of AIS.

Main Methods:

• CSF samples were collected within 24 hours of symptom onset from 118 adult patients with uncomplicated AIS.
• CSF cell counts (WBC, MNLs, PMNLs) were analyzed, with repeat examinations on day 7 for 98 patients.
• Patients were screened for systemic infections, inflammatory diseases, and other conditions that could affect CSF parameters.

Main Results:

• No CSF cells were found in 66.1% of patients; 21.2% had 1-4 mononuclear leukocytes (MNLs).
• Only 12.7% of patients exhibited CSF pleocytosis (≥5 MNLs or ≥1 polymorphonuclear leukocyte), and it was consistently mild (highest WBC count 15 cells/mL).
• CSF pleocytosis was rare on day 7, primarily observed in cases with traumatic lumbar puncture.

Conclusions:

• CSF pleocytosis is uncommon and mild in uncomplicated AIS.
• CSF cellular analysis, including pleocytosis, appears to have limited diagnostic value for uncomplicated AIS.
• Findings suggest that routine CSF examination may not be beneficial for diagnosing uncomplicated AIS.