The cytology of cerebrospinal fluid associated with neonatal intraventricular hemorrhage

We describe the morphologic features seen in cytocentrifuge preparations of cerebrospinal fluid (CSF) from neonates with intraventricular hemorrhage (IVH). These CSF specimens from lumbar punctures or ventricular taps often contain degenerated red blood cells with blebs and buds, forming microspherocytes resembling budding yeast or cocci. Hemosiderin-laden macrophages and foamy histiocytes occur in early specimens and persist through multiple specimens. Hematoidin, foreign body giant cells, and CSF eosinophilia are later findings. Brain tissue fragments are frequently seen at the time of ventricular shunt placement. These cytocentrifuge specimens are essentially cytology specimens and in children should be reviewed by a qualified pathologist to interpret the findings in a clinically relevant manner.