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Cerebrospinal fluid:serum glucose ratio in the ventricular and lumbar compartments: implications for clinical practice
Author(s) -
Hegen H.,
Walde J.,
Auer M.,
Deisenhammer F.
Publication year - 2018
Publication title -
european journal of neurology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.881
H-Index - 124
eISSN - 1468-1331
pISSN - 1351-5101
DOI - 10.1111/ene.13513
Subject(s) - medicine , cerebrospinal fluid , clinical practice , lumbar , lumbar puncture , surgery , physical therapy
Background and purpose Calculation of the cerebrospinal fluid:serum glucose ( CSF : S G lu ) ratio is part of the routine cerebrospinal fluid ( CSF ) work‐up. Reference values have been defined for lumbar CSF , but are lacking for ventricular CSF . The objective of this study was to investigate whether the CSF : S G lu ratio is similar in lumbar and ventricular compartments, and to determine cut‐off values for CSF : S G lu ratio in ventricular CSF . Methods We included CSF samples that were collected by either lumbar puncture or ventricular drainage, with a red blood cell count <500/μL, normal white blood cell count and age‐related normal total protein content, with simultaneously withdrawn serum sample and time to laboratory processing of ≤2 h. This resulted in 1808 sample pairs. Glucose concentrations in CSF and serum were measured by enzymatic spectrophotometry. Results The CSF : S G lu ratio was similar in ventricular and lumbar compartments after controlling for age, sex, time between sample withdrawal and laboratory processing, CSF white blood cell and red blood cell count, CSF total protein and serum glucose concentration using a multiple linear regression model. Lower limits for CSF : S G lu ratio in the ventricular compartment, defined as 5 th percentile, were 0.51 for patients with serum glucose concentration < 100 mg/dL, 0.45 for those with serum glucose concentration ≥ 100 mg/dL and <150 mg/dL, and 0.36 for those with serum glucose concentration ≥150 mg/dL. Conclusions The CSF : S G lu ratio was similar in the ventricular and lumbar compartments, and depended mainly on time to laboratory processing and absolute serum glucose levels. Previously established lower limits for CSF : S G lu ratio in lumbar CSF can be also applied for ventricular CSF .