La diagnosi di liquorrea nasale e post-chirurgica

Translated title of the contribution: Diagnosis of cerebrospinal fluid (CSF) rhinorrhoea and of post-surgical CSF leakage

Gaetano Bernardi, Gabriella Passerini, Giuseppe Previtali, Emilio Ciusani

Research output: Contribution to journalArticle

Abstract

Pathological CSF leakage outside central nervous system is a very dangerous situation with high risk of meningitis and cerebral abscess. Rhinorrhoea and post-surgical CSF leakage are the most frequent conditions. Diagnosis is made by combination of imaging procedures, radionucleide cisternography via lumbar puncture (fluorescein) and biochemical tests, which utilize markers suggesting the presence of CSF in suspected fluid. Low CSF glucose concentrations suggest rhinorrhoea, as glucose is absent in nose secretion, but cannot be used in post-surgical leakage, as blood is nearly almost present. CSF proteins are the best biomarkers and intrathecal synthesized β-trace protein and transferrin are the best choice. For quantitative analysis, nephelometric β-trace protein measurement has the best performance, as it can be easily automatically performed, also for stat analysis, but relatively high volume of sample is needed. Isoelectricfocusing or high resolution electrophoresis followed by immunodetection are the most sensitive and specific methods for detecting asialotransferrin, but they are time consuming, unsuitable for stat analysis, even if they need low amounts of sample. Other quantitative tests include prealbumin/albumin ratio, having insufficient sensitivity in blood contaminated samples, and zone electrophoresis of protein pattern that, however, has too low sensitivity. New methods like capillary electrophoresis have been recently proposed.

Translated title of the contributionDiagnosis of cerebrospinal fluid (CSF) rhinorrhoea and of post-surgical CSF leakage
Original languageItalian
Pages (from-to)183-190
Number of pages8
JournalBiochimica Clinica
Volume38
Issue number3
Publication statusPublished - 2014

ASJC Scopus subject areas

  • Clinical Biochemistry
  • Biochemistry, medical
  • Medical Laboratory Technology

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