• Siri Hylleraas Bø, Ellen Katrine Rud, and Gunnhild S Kravdal.
• Nevrologisk avdeling, Akershus universitetssykehus, 1474 Nordbyhagen. s-hill-b@online.no
• Tidsskr. Nor. Laegeforen. 2005 Aug 25; 125 (16): 2192-4.

AbstractIn the examination of a patient with acute headache in which subarachnoid haemorrhage is suspected, a CT scan of the brain should be performed without delay. If the CT scan does not confirm subarachnoid haemorrhage, the next step is a lumbar puncture. This should not take place before twelve hours have elapsed from the start of the headache, so as to allow for the formation of sufficient amounts of bilirubin to be detected in a possible subarachnoid haemorrhage. Bilirubin colours the spinal fluid characteristically yellow and is detectable for at least two weeks following a subarachnoid haemorrhage. Spectrophotometric detection of bilirubin in the spinal fluid is considered more sensitive than visual detection. We present a case in which the spectrophotometric detection of bilirubin in the spinal fluid was the only pathological test result in the examination of a patient with acute headache. The spectrophotometric detection revealed an intracranial aneurysm, for which the patient received subsequent lifesaving surgical treatment. Spectrophotometric examination of spinal fluid has a high sensitivity rate. The test is simple to perform, is not expensive, and is within the scope of most laboratories. We present our method for spectrophotometric investigation of spinal fluid, along with practical advice.

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