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Cerebrospinal fluid findings in geriatric patients from 2008 to 2011

Lumbalpunktionsbefunde bei geriatrischen Patienten im Zeitraum von 2008–2011

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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.

Zusammenfassung

Hintergrund

Die chemische Zusammensetzung des Liquors ist altersabhängig.

Material und Methoden

Routine-Liquorparameter, Indikationen und Komplikationen der Lumbalpunktion wurden retrospektiv bei Patienten ab (n = 167) und unter (n = 36) 65 Jahren untersucht.

Ergebnisse

Die durchschnittliche Liquor-Laktatkonzentration in Abwesenheit einer Entzündung des zentralen Nervensystems (ZNS) war bei älteren Patienten geringfügig, aber signifikant höher als bei jüngeren. Bei ansonsten normalen Liquorbefunden korrelierte Laktat signifikant mit dem Alter der Patienten. Auch der Liquor-Serum-Quotient von Albumin (QAlbumin) war bei älteren Patienten signifikant höher als bei jüngeren. Die häufigste Indikation zur Durchführung einer Lumbalpunktion, der Verdacht auf eine Infektion des ZNS (n = 110), wurde in 12,7% der Fälle bestätigt. Nur 2 Patienten litten an postpunktionellen Kopfschmerzen.

Schlussfolgerung

Erhöhungen des QAlbumin und der Liquor-Laktatkonzentration scheinen unspezifische Befunde bei älteren Patienten zu sein. Die häufigste Indikation zur Liquorentnahme, der Verdacht auf eine Infektion des ZNS, wurde in über 10% der Fälle durch Liquoranalyse bestätigt. Angesichts der sehr niedrigen Komplikationsrate ist die Lumbalpunktion ein wertvolles Verfahren in der diagnostischen Routine bei älteren Patienten mit ZNS-Erkrankungen.

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Acknowledgement

This study was supported and funded by the Robert Bosch Foundation (to M. Djukic) and by Sparkasse Göttingen (to R. Nau).

Conflict of interest

The corresponding author states that there are no conflicts of interest.

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Authors and Affiliations

  1. Department of Neuropathology, University Medical Center Goettingen, Robert-Koch-Str. 40, 37075, Goettingen, Germany

    M. Djukic, D. Schulz & R. Nau

  2. Department of Neurology, University Medical Center Goettingen, Robert-Koch-Str. 40, 37075, Goettingen, Germany

    H. Schmidt & P. Lange

  3. Department of Geriatrics, Evangelisches Krankenhaus Goettingen-Weende, An der Lutter 24, 37075, Goettingen, Germany

    M. Djukic & R. Nau

Authors
  1. M. Djukic
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  2. D. Schulz
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  3. H. Schmidt
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  4. P. Lange
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  5. R. Nau
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Correspondence to M. Djukic.

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Djukic, M., Schulz, D., Schmidt, H. et al. Cerebrospinal fluid findings in geriatric patients from 2008 to 2011. Z Gerontol Geriat 46, 353–357 (2013). https://doi.org/10.1007/s00391-012-0380-9

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  • DOI: https://doi.org/10.1007/s00391-012-0380-9

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