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Laboratory Medicine

Test Directory / CSF Xanthochromia

CSF Xanthochromia

White topped universal (no additives)

TestCSF Xanthochromia
Common AbbreviationsXantho CSF Scan
Tube typeWhite topped universal (no additives)
Clinical IndicationAnalysis of CSF is used as a second line investigation in those patients whose CT scan was negative where there is a strong clinical suspicion of SAH as well as in those patients who present late. Haemoglobin and bilirubin do not normally cross the blood brain barrier except through haemorrhage. Following the appearance of blood in the CSF the erythrocytes lyse and liberate oxyhaemoglobin which is then converted to bilirubin. Oxyhaemoglobin can be associated with recent bleeding into CSF and trauma during the lumbar puncture. The presence of oxyhaemoglobin and bilirubin in CSF is suggestive of SAH.
Specimen TypeCSF
Sample typeCSF (protected from the light)
Minimum Volume200µl
Special PrecautionsProtect from light. Transport to laboratory by hand. Ensure >12 hours since onset of headache
Stability<1 hour if not light protected and at least 24 hours if light protected
Turnaround TimeUrgent: 4 hours Non-Urgent: 12 hours
Reference IntervalInterpretative result provided The net bilirubin absorbance (NBA) is reported as a numerical value with a cut off level of 0.007 between suspicion or exclusion of a subarachnoid haemorrhage (SAH) event. The net oxyhaemoglobin absorbance is reported as detected or not detected with a cut off level of 0.02.
LimitationsSamples must be collected greater than 12 hours and less that 2 weeks since the onset of headache. High CSF oxyhaemoglobin, CSF total protein or serum bilirubin may affect interpretation.
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