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Background:

Diagnosis of sub-arachnoid haemorrhage following negative CT scan.

Analysis of CSF xanthochromia is only appropriate if:

• At least 12 hours have elapsed since symptom onset 
• A CT scan has been performed prior to lumbar puncture with no bleed identified
• Relevant clinical details are provided

CSF samples must be received protected from the light, and should not be transported via the pneumatic pod system.

Other Comments:

Samples are analysed according to national guidelines (Revised national guidelines for analysis of cerebrospinal fluid for bilirubin in suspected subarachnoid haemorrhage; Cruickshank et al. Ann Clin Biochem 2008; 45: 238–244).

Please contact the Duty Biochemist if further discussion is needed.