Skip to main content
Erschienen in: Zeitschrift für Gerontologie und Geriatrie 4/2013

01.06.2013 | Original Contribution

Cerebrospinal fluid findings in geriatric patients from 2008 to 2011

verfasst von: M. Djukic, D. Schulz, H. Schmidt, P. Lange, R. Nau

Erschienen in: Zeitschrift für Gerontologie und Geriatrie | Ausgabe 4/2013

Einloggen, um Zugang zu erhalten

Abstract

Background

The chemical composition of the cerebrospinal fluid (CSF) is age-dependent.

Methods

Routine CSF parameters, the indications for lumbar puncture (LP), and the most frequent complications were retrospectively studied in patients older (n = 167) and younger (n = 36) than 65 years.

Results

In the absence of meningeal inflammation, the mean CSF lactate level of patients older than 65 years was slightly but significantly higher than the mean CSF lactate level of younger patients. The lactate level of patients with otherwise normal CSF findings correlated significantly with the age of the patients. In the absence of meningeal inflammation, the CSF-to-serum albumin ratio (QAlbumin) was significantly higher in older patients than in younger ones.
The most frequent indication for LP, suspected infection of the central nervous system (CNS) (n = 110), was confirmed in 12.7% of patients. The only LP complication documented was headache in two patients.

Conclusions

Elevations of QAlbumin and CSF lactate levels appear to be nonspecific findings in elderly patients. Suspected infections, the most frequent indication for LP, were confirmed by CSF analysis in more than 10% of patients. The very low complication rate of LP makes it a very valuable tool in the diagnostic routine for older patients with CNS diseases.
Literatur
1.
Zurück zum Zitat Armon C, Evans RW (2005) Addendum to assessment: prevention of post-lumbar puncture headaches: report of the Therapeutics and Technology Assessment Subcommittee of the American Academy of Neurology. Neurology 65:510–512PubMedCrossRef Armon C, Evans RW (2005) Addendum to assessment: prevention of post-lumbar puncture headaches: report of the Therapeutics and Technology Assessment Subcommittee of the American Academy of Neurology. Neurology 65:510–512PubMedCrossRef
2.
Zurück zum Zitat Biesiada G, Czepiel J, Sobczyk-Krupiarz I et al (2010) Neurological complications among patients with zoster hospitalized in Department of Infectious Diseases in Cracow in 2001–2006. Przegl Lek 67:149–150PubMed Biesiada G, Czepiel J, Sobczyk-Krupiarz I et al (2010) Neurological complications among patients with zoster hospitalized in Department of Infectious Diseases in Cracow in 2001–2006. Przegl Lek 67:149–150PubMed
3.
Zurück zum Zitat Blennow K, Fredman P, Wallin A et al (1993) Protein analysis in cerebrospinal fluid. II. Reference values derived from healthy individuals 18–88 years of age. Eur Neurol 33:129–133PubMedCrossRef Blennow K, Fredman P, Wallin A et al (1993) Protein analysis in cerebrospinal fluid. II. Reference values derived from healthy individuals 18–88 years of age. Eur Neurol 33:129–133PubMedCrossRef
4.
Zurück zum Zitat Brettschneider J, Claus A, Kassubek J, Tumani H (2005) Isolated blood–cerebrospinal fluid barrier dysfunction: prevalence and associated diseases. J Neurol 252:1067–1073PubMedCrossRef Brettschneider J, Claus A, Kassubek J, Tumani H (2005) Isolated blood–cerebrospinal fluid barrier dysfunction: prevalence and associated diseases. J Neurol 252:1067–1073PubMedCrossRef
5.
Zurück zum Zitat Brouns R, Sheorajpanday R, Wauters A et al (2008) Evaluation of lactate as a marker of metabolic stress and cause of secondary damage in acute ischemic stroke or TIA. Clin Chim Acta 397:27–31PubMedCrossRef Brouns R, Sheorajpanday R, Wauters A et al (2008) Evaluation of lactate as a marker of metabolic stress and cause of secondary damage in acute ischemic stroke or TIA. Clin Chim Acta 397:27–31PubMedCrossRef
6.
Zurück zum Zitat Conly JM, Ronald AR (1983) Cerebrospinal fluid as a diagnostic body fluid. Am J Med 75:102–107PubMedCrossRef Conly JM, Ronald AR (1983) Cerebrospinal fluid as a diagnostic body fluid. Am J Med 75:102–107PubMedCrossRef
7.
Zurück zum Zitat Corning JL (1885) Spinal anaesthesia and local medication of the cord. NY State Med J 42:483 Corning JL (1885) Spinal anaesthesia and local medication of the cord. NY State Med J 42:483
8.
Zurück zum Zitat Cunha BA, Strollo S, Durie N, Ibrahim MS (2011) Facial herpes zoster complicated by varicella zoster virus (VZV) encephalitis: The diagnostic significance of atypical lymphocytes in cerebrospinal fluid (CSF). Heart Lung 40:164–167PubMedCrossRef Cunha BA, Strollo S, Durie N, Ibrahim MS (2011) Facial herpes zoster complicated by varicella zoster virus (VZV) encephalitis: The diagnostic significance of atypical lymphocytes in cerebrospinal fluid (CSF). Heart Lung 40:164–167PubMedCrossRef
9.
Zurück zum Zitat Dakka Y, Warra N, Albadareen RJ et al (2011) Headache rate and cost of care following lumbar puncture at a single tertiary care hospital. Neurology 77:71–74PubMedCrossRef Dakka Y, Warra N, Albadareen RJ et al (2011) Headache rate and cost of care following lumbar puncture at a single tertiary care hospital. Neurology 77:71–74PubMedCrossRef
10.
Zurück zum Zitat De Greef GE, Tol MJ van, Berg JW van den et al (1992) Serum immunoglobulin class and IgG subclass levels and the occurrence of homogeneous immunoglobulins during the course of ageing in humans. Mech Ageing Dev 66:29–44CrossRef De Greef GE, Tol MJ van, Berg JW van den et al (1992) Serum immunoglobulin class and IgG subclass levels and the occurrence of homogeneous immunoglobulins during the course of ageing in humans. Mech Ageing Dev 66:29–44CrossRef
12.
Zurück zum Zitat Finsterer J (2001) Cerebrospinal-fluid lactate in adult mitochondriopathy with and without encephalopathy. Acta Med Austriaca 28:152–155PubMedCrossRef Finsterer J (2001) Cerebrospinal-fluid lactate in adult mitochondriopathy with and without encephalopathy. Acta Med Austriaca 28:152–155PubMedCrossRef
13.
Zurück zum Zitat Flaatten H, Kråkenes J, Vedeler C (1998) Post-dural puncture related complications after diagnostic lumbar puncture, myelography and spinal anaesthesia. Acta Neurol Scand 98:445–451PubMedCrossRef Flaatten H, Kråkenes J, Vedeler C (1998) Post-dural puncture related complications after diagnostic lumbar puncture, myelography and spinal anaesthesia. Acta Neurol Scand 98:445–451PubMedCrossRef
14.
Zurück zum Zitat Gopal DM, Kalogeropoulos AP, Georgiopoulou VV et al (2010) Serum albumin concentration and heart failure risk The Health, Aging, and Body Composition Study. Am Heart J 160:279–285PubMedCrossRef Gopal DM, Kalogeropoulos AP, Georgiopoulou VV et al (2010) Serum albumin concentration and heart failure risk The Health, Aging, and Body Composition Study. Am Heart J 160:279–285PubMedCrossRef
15.
Zurück zum Zitat Hindley NJ, Jobst KA, King E et al (1995) High acceptability and low morbidity of diagnostic lumbar puncture in elderly subjects of mixed cognitive status. Acta Neurol Scand 91:405–411PubMedCrossRef Hindley NJ, Jobst KA, King E et al (1995) High acceptability and low morbidity of diagnostic lumbar puncture in elderly subjects of mixed cognitive status. Acta Neurol Scand 91:405–411PubMedCrossRef
16.
Zurück zum Zitat Jesse S, Brettschneider J, Süssmuth SD et al (2011) Summary of cerebrospinal fluid routine parameters in neurodegenerative diseases. J Neurol 258:1034–1041PubMedCrossRef Jesse S, Brettschneider J, Süssmuth SD et al (2011) Summary of cerebrospinal fluid routine parameters in neurodegenerative diseases. J Neurol 258:1034–1041PubMedCrossRef
17.
Zurück zum Zitat Lehmnitz R, Hobusch D, Kluge H et al (2005) Referenzwerte für Liquorparameter mit diagnostischer Relevanz. In: Zettl U, Lehmnitz R, Mix E, Klinische Liquordiagnostik, 2. Aufl. Walter de Gruyter, Berlin, S 88–94 Lehmnitz R, Hobusch D, Kluge H et al (2005) Referenzwerte für Liquorparameter mit diagnostischer Relevanz. In: Zettl U, Lehmnitz R, Mix E, Klinische Liquordiagnostik, 2. Aufl. Walter de Gruyter, Berlin, S 88–94
18.
Zurück zum Zitat Marmarou A, Bergsneider M, Klinge P et al (2005) The value of supplemental prognostic tests for the preoperative assessment of idiopathic normal-pressure hydrocephalus. Neurosurgery 57:17–28CrossRef Marmarou A, Bergsneider M, Klinge P et al (2005) The value of supplemental prognostic tests for the preoperative assessment of idiopathic normal-pressure hydrocephalus. Neurosurgery 57:17–28CrossRef
19.
Zurück zum Zitat Nagel MA, Cohrs RJ, Mahalingam R et al (2008) The varicella zoster virus vasculopathies: clinical, CSF, imaging, and virologic features. Neurology 70:853–860PubMedCrossRef Nagel MA, Cohrs RJ, Mahalingam R et al (2008) The varicella zoster virus vasculopathies: clinical, CSF, imaging, and virologic features. Neurology 70:853–860PubMedCrossRef
20.
Zurück zum Zitat Parnetti L, Gaiti A, Polidori MC et al (1995) Increased cerebrospinal fluid pyruvate levels in Alzheimer’s disease. Neurosci Lett 199:231–233PubMedCrossRef Parnetti L, Gaiti A, Polidori MC et al (1995) Increased cerebrospinal fluid pyruvate levels in Alzheimer’s disease. Neurosci Lett 199:231–233PubMedCrossRef
21.
Zurück zum Zitat Quincke H (1891) Über Hydrocephalus. Verhandl Cong Inn Med 10:321 Quincke H (1891) Über Hydrocephalus. Verhandl Cong Inn Med 10:321
22.
Zurück zum Zitat Ratzka P, Schlachetzki JC, Bähr M, Nau R (2006) Varicella zoster virus cerebellitis in a 66-year-old patient without herpes zoster. Lancet 367:182PubMedCrossRef Ratzka P, Schlachetzki JC, Bähr M, Nau R (2006) Varicella zoster virus cerebellitis in a 66-year-old patient without herpes zoster. Lancet 367:182PubMedCrossRef
23.
Zurück zum Zitat Report of the Quality Standards Subcommittee of the American Academy of Neurology. Practice parameters: lumbar puncture (1993). Neurology 43:625–627CrossRef Report of the Quality Standards Subcommittee of the American Academy of Neurology. Practice parameters: lumbar puncture (1993). Neurology 43:625–627CrossRef
24.
Zurück zum Zitat Reiber H, Felgenhauer K (1987) Protein transfer at the blood cerebrospinal fluid barrier and the quantitation of the humoral immune response within the central nervous system. Clin Chim Acta 163:319–328PubMedCrossRef Reiber H, Felgenhauer K (1987) Protein transfer at the blood cerebrospinal fluid barrier and the quantitation of the humoral immune response within the central nervous system. Clin Chim Acta 163:319–328PubMedCrossRef
25.
Zurück zum Zitat Reiber H, Lange P (1991) Quantification of virus-specific antibodies in cerebrospinal fluid and serum: sensitive and specific detection of antibody synthesis in brain. Clin Chem 37:1153–1160PubMed Reiber H, Lange P (1991) Quantification of virus-specific antibodies in cerebrospinal fluid and serum: sensitive and specific detection of antibody synthesis in brain. Clin Chem 37:1153–1160PubMed
26.
Zurück zum Zitat Reiber H, Otto M, Trendelenburg C, Wormek A (2001) Reporting cerebrospinal fluid data: knowledge base and interpretation software. Clin Chem Lab Med 39:324–332PubMedCrossRef Reiber H, Otto M, Trendelenburg C, Wormek A (2001) Reporting cerebrospinal fluid data: knowledge base and interpretation software. Clin Chem Lab Med 39:324–332PubMedCrossRef
27.
Zurück zum Zitat Reiber H (2010) Lactate and Glucose. In: Wildemann B, Oschmann P, Reiber H (Hrsg) Laboratory diagnosis in neurology. Thieme, Stuttgart, S 56–59 Reiber H (2010) Lactate and Glucose. In: Wildemann B, Oschmann P, Reiber H (Hrsg) Laboratory diagnosis in neurology. Thieme, Stuttgart, S 56–59
28.
29.
Zurück zum Zitat Statistisches Bundesamt: Krankenhausdiagnostik- Diagnosedaten der Patienten und Patientinnen in Krankenhäusern. http://www.gbe-bund.de Statistisches Bundesamt: Krankenhausdiagnostik- Diagnosedaten der Patienten und Patientinnen in Krankenhäusern. http://​www.​gbe-bund.​de
30.
Zurück zum Zitat Strupp M, Schueler O, Straube A et al (2001) “Atraumatic” Sprotte needle reduces the incidence of post-lumbar puncture headaches. Neurology 57:2310–2312PubMedCrossRef Strupp M, Schueler O, Straube A et al (2001) “Atraumatic” Sprotte needle reduces the incidence of post-lumbar puncture headaches. Neurology 57:2310–2312PubMedCrossRef
31.
Zurück zum Zitat Tavazzi E, Minoli L, Ferrante P et al (2008) Varicella zoster virus meningo-encephalo-myelitis in an immunocompetent patient. Neurol Sci 29:279–283PubMedCrossRef Tavazzi E, Minoli L, Ferrante P et al (2008) Varicella zoster virus meningo-encephalo-myelitis in an immunocompetent patient. Neurol Sci 29:279–283PubMedCrossRef
32.
Zurück zum Zitat Weber-Mzell D, Kotanko P, Hauer AC et al (2004) Gender, age and seasonal effects on IgA deficiency: a study of 7293 Caucasians. Eur J Clin Invest 34:224–228PubMedCrossRef Weber-Mzell D, Kotanko P, Hauer AC et al (2004) Gender, age and seasonal effects on IgA deficiency: a study of 7293 Caucasians. Eur J Clin Invest 34:224–228PubMedCrossRef
33.
Zurück zum Zitat Wellmer A, Prange J, Gerber J et al (2001) D- and L-lactate in rabbit and human bacterial meningitis. Scand J Infect Dis 33:909–913PubMedCrossRef Wellmer A, Prange J, Gerber J et al (2001) D- and L-lactate in rabbit and human bacterial meningitis. Scand J Infect Dis 33:909–913PubMedCrossRef
Metadaten
Titel
Cerebrospinal fluid findings in geriatric patients from 2008 to 2011
verfasst von
M. Djukic
D. Schulz
H. Schmidt
P. Lange
R. Nau
Publikationsdatum
01.06.2013
Verlag
Springer-Verlag
Erschienen in
Zeitschrift für Gerontologie und Geriatrie / Ausgabe 4/2013
Print ISSN: 0948-6704
Elektronische ISSN: 1435-1269
DOI
https://doi.org/10.1007/s00391-012-0380-9

Weitere Artikel der Ausgabe 4/2013

Zeitschrift für Gerontologie und Geriatrie 4/2013 Zur Ausgabe

Mitteilungen des BV Geriatrie

Mitteilungen des BV Geriatrie

Beiträge zum Themenschwerpunkt

Haft und Haftentlassung im Alter

Mitteilungen der DGG

Mitteilungen der DGG

Mitteilungen der DGGG

Mitteilungen der DGGG