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Temporal Changes in CSF Cell Parameters After SAH: Comparison of Ventricular and Spinal Drain Samples
Jyri J Virta1, Jarno Satopää2, Teemu Luostarinen3
1Anesthesiology and Intensive Care, University of Helsinki and Helsinki University Hospital, Helsinki, Finland. jyri.virta@hus.fi.
Neurocritical Care
|February 15, 2024
Summary
Cerebrospinal fluid (CSF) cell counts change over time after aneurysmal subarachnoid hemorrhage (aSAH). Samples from external ventricular drains (EVDs) and spinal drains are not interchangeable for monitoring these changes.
Area of Science:
- Neurosurgery
- Neurology
- Critical Care Medicine
Background:
- Forty percent of aneurysmal subarachnoid hemorrhage (aSAH) patients develop acute hydrocephalus.
- Cerebrospinal fluid (CSF) cell parameters can indicate sterile inflammation post-aSAH.
- Monitoring CSF requires understanding temporal cell parameter changes.
Purpose of the Study:
- To investigate the temporal changes in CSF cell parameters after aSAH.
- To compare CSF samples derived from external ventricular drains (EVDs) and lumbar spinal drains.
Main Methods:
- Retrospective analysis of 1360 CSF samples from 197 aSAH patients.
- Mapping temporal changes in CSF leucocyte count, erythrocyte count, cell ratio, and index over 19 days.
- Comparing EVD-derived and spinal drain-derived samples using linear mixed models.
Main Results:
- CSF leucocyte count peaked at days 4-5 (EVD) and 6-7 (spinal drain).
- Cell ratio and index peaked later in spinal drain samples (days 12-15) compared to EVD samples (days 8-9).
- Spinal drain samples showed significantly higher leucocyte counts and cell ratios/indices during specific post-aSAH periods.
Conclusions:
- CSF cell parameters exhibit dynamic temporal changes following aSAH.
- CSF samples obtained from different drainage compartments (EVD vs. spinal) are not directly comparable.
- These findings highlight the importance of considering the sample source when interpreting CSF cell parameters.
