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Traditional teaching says that cerebrospinal fluid (CSF) xanthochromia that is detected by spectrophotometry is pathognomonic for subarachnoid hemorrhage, but this interpretation is problematic when a traumatic tap has introduced blood into the CSF. These authors studied an in vitro model of traumatic taps to determine time to development of CSF xanthochromia.
Researchers warmed samples of normal CSF (normal glucose and protein concentrations, no red or white blood cells) to 37°C that had been stored at 4°C in a hospital lab . Citrated or freshly drawn whole blood was added to small aliquots of CSF to yield RBC concentrations of 0; 5000; 10,000; 20,000; 30,000, and 40,000/μL. They then assessed samples for xanthochromia by spectrophotometry …