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(Stroke. 2005;36:1295.)
© 2005 American Heart Association, Inc.

Research Reports

Why Human Color Vision Cannot Reliably Detect Cerebrospinal Fluid Xanthochromia

From the Tavistock Intensive Care Unit (A.P.), The National Hospital for Neurology and Neurosurgery, and Department of Neuroimmunology, Institute of Neurology, Queen Square, London, UK; the Department of Neuroimmunology (G.K.), Institute of Neurology, Queen Square, London, UK; and the Colour and Vision Research Laboratories (T.L.S.; http://cvrl.ioo.ucl.ac.uk/index.htm), Institute of Ophthalmology, London, UK.

Correspondence to Dr Axel Petzold, the Department of Neuroimmunology, Institute of Neurology, Queen Square, London WC1N 3BG, UK. E-mail a.petzold{at}ion.ucl.ac.uk

Background— Visual assessment of cerebrospinal fluid (CSF) for xanthochromia (yellow color) is practiced by the majority of laboratories worldwide as a means of diagnosing intracranical bleeds.

Methods— Colorimetric and spectrophotometric analysis of CSF samples for recognizing the presence of bilirubin either in low concentrations or in the presence of hemolysed blood.

Results— The experiments provide the physiological and colorimetric basis for abandoning visual assessment of CSF for xanthochromia.

Conclusion— We strongly recommend relying on spectrophotometry as the analytical method of choice.

Key Words: cerebrospinal fluid • intracerebral hemorrhage • subarachnoid hemorrhage

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