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Xanthochromia, from the Greek xanthos (ξανθός) "yellow" and chroma (χρώμα) "colour", is the yellowish appearance of cerebrospinal fluid that occurs several hours after bleeding into the subarachnoid space caused by certain medical conditions, most commonly subarachnoid hemorrhage. [1]
Xanthochromia remains a reliable ways to detect SAH several days after the onset of headache. [36] An interval of at least 12 hours between the onset of the headache and lumbar puncture is required, as it takes several hours for the hemoglobin from the red blood cells to be metabolized into bilirubin. [4] [36]
However, patients with confirmed CSF leaks may also demonstrate completely normal opening pressures. In 18–46% of cases, the CSF pressure is measured within the normal range. [24] [73] [74] [75] Analysis of spinal fluid may demonstrate lymphocytic pleocytosis and elevated protein content or xanthochromia. This is hypothesized to be due to ...
In newborns, CSF pressure ranges from 8 to 10 cmH 2 O (4.4–7.3 mmHg or 0.78–0.98 kPa). Most variations are due to coughing or internal compression of jugular veins in the neck. When lying down, the CSF pressure as estimated by lumbar puncture is similar to the intracranial pressure .
Froin's syndrome – coexistence of xanthochromia, high protein level and marked coagulation of cerebrospinal fluid (CSF). It is caused by meningeal irritation (e.g. during spinal meningitis) and CSF flow blockage by tumour mass or abscess. [1]
The test involves removing 30–50 ml of CSF through a lumbar puncture, after which motor and cognitive function is clinically reassessed. [1] The name "Fisher test" is after C. Miller Fisher , a Canadian neurologist working in Boston, Massachusetts, who described the test.
Though exact concentrations differ based on the specific disease, mild cases of lymphocytic pleocytosis are considered to begin when lymphocyte counts enter the range of 10-100 cells per mm 3. [1] In healthy individuals, only 0-5 white blood cells per μL are normally present in the CSF. [ 2 ]
In addition, damage to small blood vessels during lumbar puncture (traumatic tap) can lead to an increased CSF glucose since the blood that enters the collected CSF sample contains higher levels of glucose. [4] CSF glucose levels do not generally exceed 16.7 mmol/L (300 mg/dL). [3]