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Chemical and cytological analysis of cerebral spinal fluid after intrathecal injection of hypodense fluorescein Please cite this article as: Guimarães RES, Stamm AEC, Giannetti AV, Crosara PFTB, Becker CG, Becker HMG. Chemical and cytological analysis of cerebral spinal fluid after intrathecal injection of hypodense fluorescein. Braz J Otorhinolaryngol. 2015;81:549-53. ☆☆ ☆☆ Institution: Faculdade de Medicina, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, Minas Gerais, MG, Brazil.

ABSTRACT

INTRODUCTION:

Intrathecal fluorescein has been effective for topographic diagnosis of rhinoliquorrhea. Nonetheless, there are no reports on the study of cerebral spinal fluid (CSF) after use of intrathecal fluorescein.

OBJECTIVE:

A prospective study attempting to evaluate CSF through chemical and cytological analysis, after injection of fluorescein.

METHODS:

Prospective analysis of 24 samples of CSF after intrathecal injection of fluorescein for topographic diagnosis of CSF fistulae, collected at the time of puncture and after 24 and 48 h, divided by cellularity: Group 1, up to five cells, and Group 2, with more than five cells.

RESULTS:

The yellow-greenish color of CSF remained after 48 h in 36%, evidencing permanence of fluorescein. No changes in protein and glucose levels were observed between 0-24 h and 0-48 h. In group 2, an increase in cell count was observed between 24 h and 48 h (p = 0.019). In both groups, there was an increase of neutrophils between 0 and 48 h (p = 0.048) and a decrease between 24 and 48 h (p = 0.05).

CONCLUSION:

Intrathecal fluorescein provoked discreet meningeal reactions, such as an increase of cells between 24 and 48 h and an increase of neutrophils at 24 h, with a subsequent decrease at 48 h with no correlation with symptomatology.

Keywords:
Fluorescein; Cerebrospinal fluid rhinorrhea; Leakage

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