Tumani H, Petzold A, Wick M, Kühn H-J, Uhr M, Otto M, Regeniter A, Brettschneider J
Abteilung für Neurology, Universität Ulm, Oberer Eselsberg 45, 89081, Ulm, Deutschland.
Nervenarzt. 2010 Aug;81(8):973-9. doi: 10.1007/s00115-010-2997-5.
The diagnostic investigation of CT-negative subarachnoid haemorrhage (SAH) is a particular challenge in clinical neurology. Cerebrospinal fluid (CSF) analysis via lumbar puncture is the method of choice. The diagnosis of SAH in CSF is based on a bloody or xanthochromic discoloration of the CSF as well as on findings in non-automated CSF cytology including the detection of erythrophages and siderophages. The automated determination of CSF ferritin concentrations or spectrophotometric detection of xanthochromia may contribute to the diagnosis but are only useful with regard to the overall clinical picture. Generally, the knowledge of the time flow of CSF changes associated with SAH is essential for a correct interpretation of CSF findings.
CT阴性的蛛网膜下腔出血(SAH)的诊断性检查是临床神经学中的一项特殊挑战。通过腰椎穿刺进行脑脊液(CSF)分析是首选方法。CSF中SAH的诊断基于CSF的血性或黄变以及非自动化CSF细胞学检查结果,包括红细胞吞噬细胞和含铁血黄素吞噬细胞的检测。CSF铁蛋白浓度的自动测定或黄变的分光光度检测可能有助于诊断,但仅在整体临床情况方面有用。一般来说,了解与SAH相关的CSF变化的时间进程对于正确解释CSF结果至关重要。