Is a low cerebrospinal fluid blood glucose ratio indicative of infection in patients with post haemorrhagic hydrocephalus?
Cerebrospinal fluid glucose and cerebrospinal fluid:blood glucose ratios were compared in seven patients with post haemorrhagic hydrocephalus having lumbar puncture/ventricular tap as a therapeutic measure. A control group of 10 babies was used, without intraventricular haemorrhage, and having lumbar puncture as part of a septic screen. Of 50 separate taps in the patient group, 38% had blood glucose measured and 76% had CSF glucose measured. Median cerebrospinal fluid glucose was 1.2 mmol (range, 0.4-2.5 mmol/l) in the patient group and 3.1 mmol/l (range, 1.4-10.3 mmol/l) in the control group. The median cerebrospinal fluid:blood glucose ratio in the patient group was 0.235 (range, 0.07-0.53) and in the control group was 0.709 (range, 0.6-1.4). Hypoglycorrhachia appears to be a normal finding in patients with post haemorrhagic hydrocephalus and does not indicate infection in these infants. Measurement of cerebrospinal fluid:blood glucose ratio is not warranted when cerebrospinal fluid is drained purely as a therapeutic measure in these patients.
Green
K A
KA
Neonatal Intensive Care Unit, Fazakerley Hospital, Liverpool, UK.
Shaw
N J
NJ
D001786:Blood Glucose / Q000378:metabolism*; D002543:Cerebral Hemorrhage / Q000150:complications*; D005865:Gestational Age; D005947:Glucose / Q000134:cerebrospinal fluid*; D006801:Humans; D006849:Hydrocephalus / Q000150:complications*; D007231:Infant, Newborn; D007234:Infant, Premature; D007239:Infections / Q000097:blood / Q000134:cerebrospinal fluid; D012016:Reference Values
D001786:Blood Glucose; D005947:Glucose