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The diagnostic accuracy of CSF analyses in stroke
Acta Medica Scandinavica
|January 1, 1983
Summary
Routine cerebrospinal fluid (CSF) analysis can help distinguish between stroke types. Elevated protein levels and spectrophotometric absorbance are key indicators of cerebral hemorrhage, aiding diagnosis.
Area of Science:
- Neurology
- Clinical Chemistry
- Biochemistry
Background:
- Differentiating between hemorrhagic and ischemic stroke is critical for timely and appropriate patient management.
- Cerebrospinal fluid (CSF) analysis is a readily available diagnostic tool in stroke evaluation.
- Computed tomography (CT) and autopsy are gold standards for stroke diagnosis.
Purpose of the Study:
- To evaluate the efficacy of routine cerebrospinal fluid (CSF) analyses in differentiating between hemorrhagic stroke and ischemic infarction.
- To determine the diagnostic accuracy of CSF protein levels and spectrophotometric absorbance for identifying cerebral hemorrhage.
Main Methods:
- Retrospective analysis of CSF from 231 stroke patients with confirmed diagnoses via CT or autopsy.
- Measurement of CSF protein levels and spectrophotometric absorbance at various wavelengths (410, 415, 455, 630 nm).
- Calculation of sensitivity and specificity for diagnostic thresholds of protein concentration and absorbance.
Main Results:
- Mean CSF protein levels were elevated in all diagnostic groups, with the highest values observed in hemorrhagic stroke.
- A CSF protein level > 1 g/l demonstrated 89% sensitivity and 92% specificity for hemorrhage.
- CSF absorbance ≥ 0.040 at 415 nm showed 72% sensitivity and 94% specificity for hemorrhage, comparable to visual assessment.
Conclusions:
- Routine CSF analysis, particularly protein levels and spectrophotometric absorbance, offers valuable diagnostic information for differentiating hemorrhagic stroke from infarction.
- While effective, CSF analysis may lead to misdiagnosis in a subset of patients, highlighting the need for integrated diagnostic approaches.