NDLI: Validation of cerebrospinal fluid findings in aneurysmal subarachnoid hemorrhage.

Content Provider	World Health Organization (WHO)-Global Index Medicus
Author	Mark, Dustin G. Kene, Mamata V. Offerman, Steven R. Vinson, David R. Ballard, Dustin W.
Organization	Kaiser Permanente CREST Network
Description	Country affiliation: Canada Author Affiliation: Mark DG ( Department of Emergency Medicine, Kaiser Permanente, Oakland, CA.); Kene MV ( Department of Emergency Medicine, Kaiser Permanente, San Leandro, CA.); Offerman SR ( Department of Emergency Medicine, Kaiser Permanente, South Sacramento, CA.); Vinson DR ( Department of Emergency Medicine, Kaiser Permanente, Roseville, CA); Ballard DW ( Kaiser Permanente Division of Research, Oakland, CA)
Abstract	BACKGROUND: Recently proposed cutoff criteria for cerebrospinal fluid (CSF) analyses might safely exclude a diagnosis of aneurysmal subarachnoid hemorrhage (aSAH). OBJECTIVE: The objective of this study was to examine the sensitivity of a CSF red blood cell (RBC) count greater than 2000 × 10(6)/L (ie, 2000 RBCs per microliter) or the presence of visible CSF xanthochromia in identifying patients with aSAH. METHODS: We identified a retrospective case series of patients diagnosed with aSAH after lumbar puncture (LP) in an integrated health delivery system between January 2000 and June 2013 by chart review. All identified patients had at least 1 cerebral aneurysm that was treated with a neurosurgical or endovascular intervention during the index hospitalization. The lowest CSF RBC count was used for validation analysis. Cerebrospinal fluid color was determined by visual inspection. Xanthochromia was defined as pink, orange, or yellow pigmentation of CSF supernatant. RESULTS: Sixty-four patients met study inclusion criteria. Of these, 17 (33%) of 52 underwent LP within 12 hours of headache onset, and 49 (84%) of 58 exhibited CSF xanthochromia. The median CSF RBC count was 63250 × 10(6)/L. The sensitivity of a CSF RBC count of greater than 2000 × 10(6)/L in identifying aSAH was 96.9% (95% confidence interval, 89.3%-99.1%). Additional consideration of CSF xanthochromia resulted in a sensitivity of 100% (95% confidence interval, 94.3%-100%). CONCLUSIONS: All patients in this case series of patients with aSAH had either a CSF RBC count greater than 2000 × 10(6)/L or visible CSF xanthochromia, increasing the likelihood that this proposed cutoff strategy may safely identify patients who warrant further investigation for an aneurysmal cause of subarachnoid hemorrhage.
File Format	HTM / HTML
ISSN	07356757
Issue Number	9
Volume Number	33
e-ISSN	15328171
Journal	The American Journal of Emergency Medicine
Language	English
Publisher	Elsevier
Publisher Date	2015-09-01
Publisher Place	United States
Access Restriction	One Nation One Subscription (ONOS)
Subject Keyword	Discipline Emergency Discipline Medicine Emergency Service, Hospital Intracranial Aneurysm Cerebrospinal Fluid Diagnosis Subarachnoid Hemorrhage Aged Cohort Studies Erythrocyte Count Female Humans Male Middle Aged Predictive Value Of Tests Reproducibility Of Results Spinal Puncture Clinical Study Journal Article Research Support, Non-u.s. Gov't
Content Type	Text
Resource Type	Article
Subject	Emergency Medicine

Sl.	Authority	Responsibilities	Communication Details
1	Ministry of Education (GoI), Department of Higher Education	Sanctioning Authority	https://www.education.gov.in/ict-initiatives
2	Indian Institute of Technology Kharagpur	Host Institute of the Project: The host institute of the project is responsible for providing infrastructure support and hosting the project	https://www.iitkgp.ac.in
3	National Digital Library of India Office, Indian Institute of Technology Kharagpur	The administrative and infrastructural headquarters of the project	Dr. B. Sutradhar bsutra@ndl.gov.in
4	Project PI / Joint PI	Principal Investigator and Joint Principal Investigators of the project	Dr. B. Sutradhar bsutra@ndl.gov.in Prof. Saswat Chakrabarti will be added soon
5	Website/Portal (Helpdesk)	Queries regarding NDLI and its services	support@ndl.gov.in
6	Contents and Copyright Issues	Queries related to content curation and copyright issues	content@ndl.gov.in
7	National Digital Library of India Club (NDLI Club)	Queries related to NDLI Club formation, support, user awareness program, seminar/symposium, collaboration, social media, promotion, and outreach	clubsupport@ndl.gov.in
8	Digital Preservation Centre (DPC)	Assistance with digitizing and archiving copyright-free printed books	dpc@ndl.gov.in
9	IDR Setup or Support	Queries related to establishment and support of Institutional Digital Repository (IDR) and IDR workshops	idr@ndl.gov.in

Differentiation between traumatic tap and aneurysmal subarachnoid hemorrhage: prospective cohort study

Liquordiagnostik bei CT-negativer Subarachnoidalblutung.

Ruptured aneurysmal subarachnoid hemorrhage in the emergency department: Clinical outcome of patients having a lumbar puncture for red blood cell count, visual and spectrophotometric xanthochromia after a negative computed tomography.

Predictive Factors for Rebleeding After Aneurysmal Subarachnoid Hemorrhage: Rebleeding Aneurysmal Subarachnoid Hemorrhage Study.

Low risk for subsequent subarachnoid hemorrhage for emergency department patients with headache, bloody cerebrospinal fluid, and negative findings on cerebrovascular imaging.

Emergency diagnosis of subarachnoid hemorrhage: an evidence-based debate.

Xanthochromia after subarachnoid haemorrhage needs no revisitation.

Benefit of cerebrospinal fluid spectrophotometry in the assessment of CT scan negative suspected subarachnoid haemorrhage: a diagnostic accuracy study.

The value of computed tomography angiography in determining treatment allocation for aneurysmal subarachnoid hemorrhage.

Validation of cerebrospinal fluid findings in aneurysmal subarachnoid hemorrhage.

Similar Documents

Differentiation between traumatic tap and aneurysmal subarachnoid hemorrhage: prospective cohort study

Liquordiagnostik bei CT-negativer Subarachnoidalblutung.

Ruptured aneurysmal subarachnoid hemorrhage in the emergency department: Clinical outcome of patients having a lumbar puncture for red blood cell count, visual and spectrophotometric xanthochromia after a negative computed tomography.

Predictive Factors for Rebleeding After Aneurysmal Subarachnoid Hemorrhage: Rebleeding Aneurysmal Subarachnoid Hemorrhage Study.

Low risk for subsequent subarachnoid hemorrhage for emergency department patients with headache, bloody cerebrospinal fluid, and negative findings on cerebrovascular imaging.

Emergency diagnosis of subarachnoid hemorrhage: an evidence-based debate.

Xanthochromia after subarachnoid haemorrhage needs no revisitation.

Benefit of cerebrospinal fluid spectrophotometry in the assessment of CT scan negative suspected subarachnoid haemorrhage: a diagnostic accuracy study.

The value of computed tomography angiography in determining treatment allocation for aneurysmal subarachnoid hemorrhage.

Validation of cerebrospinal fluid findings in aneurysmal subarachnoid hemorrhage.