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Spectrophotometry for cerebrospinal fluid pigment analysis

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Abstract

The use of spectrophotometry for the analysis of the cerebrospinal fluid (CSF) is reviewed The clinically relevant CSF pigments—oxyhemoglobin and bilirubin—are introduced and discussed with regard to clinical differential diagnosis and potentially confounding variables (the four T's: traumatic tap, timing, total protein and total bilirubin). The practical laboratory aspects of spectrophotometry and automated techniques are presented in the context of analytical and clinical specificity and sensitivity. The perceptual limitations of human color vision are highlighted and the use of visual assessment of the CSF is discouraged in light of recent evidence from a national audit in the United Kingdom. Finally, future perspectives including the need for longitudinal CSF profiling and routine spectrophotometric calibration are outlined.

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Authors and Affiliations

  1. Tavistock Intensive Care Unit, The National Hospital for Neurology and Neurosurgery, Queen Square, London, UK

    Axel Petzold

  2. Institute of Ophthalmology, London, UK

    Lindsay T. Sharpe

  3. Department of Neuroimmunology, Institute of Neurology, Queen Square, WC1N 3BG, London, UK

    Axel Petzold & Geoffrey Keir

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  1. Axel Petzold
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  2. Lindsay T. Sharpe
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  3. Geoffrey Keir
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Correspondence to Axel Petzold.

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Petzold, A., Sharpe, L.T. & Keir, G. Spectrophotometry for cerebrospinal fluid pigment analysis. Neurocrit Care 4, 153–162 (2006). https://doi.org/10.1385/NCC:4:2:153

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