XANTHOCHROMIA REVISITED - A RE-EVALUATION OF LUMBAR PUNCTURE AND CT SCANNING IN THE DIAGNOSIS OF SUBARACHNOID HEMORRHAGE
XANTHOCHROMIA REVISITED - A RE-EVALUATION OF LUMBAR PUNCTURE AND CT SCANNING IN THE DIAGNOSIS OF SUBARACHNOID HEMORRHAGE
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DOI：
10.1136/jnnp.51.3.342
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发表时间：
1988-03-01
影响因子：
11
通讯作者：
MENDELOW, AD
中科院分区：
文献类型：
--
作者：
MACDONALD, A;MENDELOW, AD
回顾性分析100例颅内动脉瘤破裂的CT和脑脊液表现。68例腰椎穿刺患者中有46%的患者有血染的CSF，但没有黄色素。20名患者的CT扫描上没有可见的血液：这20名患者中有7名的CSF中有血液，但没有黄色素。结论：在蛛网膜下腔出血（SAH）的诊断中，重要的是血染的CSF，而不是黄色素，并且正常的CT扫描（EMI 1010）和CSF中没有黄色素并不能排除颅内动脉瘤破裂。为了诊断SAH，可能需要进行两种检查;对于腰椎穿刺被判定为危险的患者，CT扫描作为主要检查;对于CT扫描正常的患者，腰椎穿刺作为次要检查。
The CT and cerebrospinal fluid (CSF) findings of 100 patients with ruptured intracranial aneurysms were reviewed. Forty six percent of the 68 patients who had a lumbar puncture had blood stained CSF but with no xanthochromia. There was no blood visible on the CT scan in 20 patients: seven of these 20 had blood in their CSF, but no xanthochromia. It is concluded that it is blood stained CSF that is important in the diagnosis of subarachnoid haemorrhage (SAH), and not xanthochromia, and that a normal CT scan (EMI 1010) and the absence of xanthochromia inthe CSF do not exclude a ruptured intracranial aneurysm. To diagnose SAH, it may be necessary to perform both investigations; the CT scan as the primary investigation in those patients in whom lumbar puncture is judged to be hazardous; the lumbar puncture as the secondary investigation in those patients with a normal CT scan.