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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]
[5] [92] [94] Symonds also described the use of lumbar puncture and xanthochromia in diagnosis. [95] The first surgical intervention was performed by Norman Dott, who was a pupil of Harvey Cushing then working in Edinburgh. He introduced the wrapping of aneurysms in the 1930s, and was an early pioneer in the use of angiograms. [5]
A lumbar puncture can give the symptom of a post-dural-puncture headache. A cerebrospinal fluid leak can be either cranial or spinal, and these are two different disorders. [5] A spinal CSF leak can be caused by one or more meningeal diverticula or CSF-venous fistulas not associated with an epidural leak.
The composition and rate of CSF generation are influenced by hormones and the content and pressure of blood and CSF. [3] For example, when CSF pressure is higher, there is less of a pressure difference between the capillary blood in choroid plexuses and CSF, decreasing the rate at which fluids move into the choroid plexus and CSF generation. [3]
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There have been various therapies employed into preventing the high rates of morbidity and mortality, including diuretic therapy, [16] repeated lumbar puncture, [17] streptokinase therapy [18] and a combination novel intervention called DRIFT (drainage, irrigation and fibrinolytic therapy).
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