The Diagnostic Accuracy of CSF Analyses in Stroke

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Abstract
The ability of routine analyses of CSF to differentiate between hemorrhage and infarction was evaluated in 231 stroke patients, whose diagnoses were based on computed tomography or autopsy. In all diagnostic groups the mean protein level was above normal, the highest values being associated with hemorrhage. Taking a protein level > 1 g/l to be characteristic of bleeding, sensitivity was 89% and specificity 92%. Spectrophotometric CSF absorbance was measured at wave lengths of 410, 415, 455 and 630 nm. Validity was equal for the first 3. Taking absorbance .gtoreq. 0.040 at 415 nm to be diagnostic for hemorrhage, sensitivty was 72% and specificity 94%. The human eye was almost as sensitive as spectrophotometry in this context. Thus, among 100 patients with stroke, 7-9 out of 10 plausible cases of hemorrhage would be identified by means of routine CSF analyses. At the same time, 5-9 patients with ischemic lesions would be diagnosed incorrectly as bleedings.