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Liquordiagnostik bei CT-negativer Subarachnoidalblutung

Cerebrospinal fluid-based diagnostics of CT-negative subarachnoid haemorrhage

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Zusammenfassung

Die Diagnostik CT-negativer Subarachnoidalblutungen (SAB) stellt eine besondere klinische Herausforderung dar. Die Lumbalpunktion mit Liquordiagnostik ist hierbei die diagnostische Methode der Wahl. Die Diagnose einer SAB basiert neben dem visuellen Nachweis eines blutigen bzw. xanthochrom verfärbten Liquors auf der Liquorzytologie mit dem Nachweis von Erythrophagen und Siderophagen. Andere hierzu komplementäre Untersuchungen wie ein Nachweis eines erhöhten Ferritinspiegels oder ein spektrophotometrischer Nachweis einer visuell nicht sichtbaren Xanthochromie sind im Rahmen des klinischen Gesamtbildes sinnvoll. Allgemein ist eine genaue Kenntnis des zeitlichen Ablaufs der Liquorveränderungen nach SAB notwendig, um die Wertigkeit der einzelnen Liquorveränderungen richtig einordnen zu können.

Summary

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.

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  1. Abteilung für Neurology, Universität Ulm, Oberer Eselsberg 45, 89081, Ulm, Deutschland

    H. Tumani, A. Petzold, M. Wick, H.-J. Kühn, M. Uhr, M. Otto, A. Regeniter & J. Brettschneider

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  1. H. Tumani
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  2. A. Petzold
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  3. M. Wick
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  4. H.-J. Kühn
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  8. J. Brettschneider
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Correspondence to H. Tumani.

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Tumani, H., Petzold, A., Wick, M. et al. Liquordiagnostik bei CT-negativer Subarachnoidalblutung. Nervenarzt 81, 973–979 (2010). https://doi.org/10.1007/s00115-010-2997-5

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