Should Spectrophotometry Be Used to Identify Xanthochromia in the Cerebrospinal Fluid of Alert Patients Suspected of Having Subarachnoid Hemorrhage?

To the Editor:We read with interest the article by Perry and colleagues.1 There appears to be a reluctance in North America to embrace what we believe to be the most sensitive method for demonstrating bilirubin in cerebrospinal fluid (CSF), spectrophotometry, on the basis that it is not requested, that the equipment does not exist and that it is difficult to interpret.1,2 It is then somewhat disingenuous to criticize spectrophotometry by using 4 methods, the first of which (‘traditional’) has many deficiencies which have been well documented3,4; the second of which (‘Chalmers and Kiley’)5 has been superseded by the third (‘Chalmers revised’) …