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In cases where centrifugation of the CSF sample is delayed, the supernatant might be xanthochromic. Xanthochromia is caused by the release of hemoglobin from the CSF and is characterized by viscous red-colored supernatant. For example, centrifugal separation of CSF should be performed within 30 minutes. If centrifugation is done >1 hour after lumbar puncture, xanthochromia may occur. In such cases, diluted cerebellar fluid is more accurate for red cell counts. Nevertheless, the following CSF red cell counts may be obtained in the supernatant, if xanthochromia is observed:9 - 3X106(Monocytees, slightly rarer) An amount of red cells per microliter of CSF would be expected in persons with normal systemic variables such as hematocrit.
It is assumed that the brain is not dissected, nor is the arachnoid membrane or subarachnoid space part of the arachnoid dissection. The main limitation of this technique is the narrow distribution of the two layers, the arachnoid membrane and the subarachnoid space. The precision of the two measurements in the same specimen is of the order of the thickness of CSF. In practice, the distribution of the arachnoid membrane and the subarachnoid space is practically impossible to obtain in one specimen. When the CSF is collected in patients with MSA, the actual distribution of the two layers may be quite different from the known distribution of the layers in other cerebrospinal fluid diseases. The actual distribution of the arachnoid membrane and the subarachnoid space is probably the same as in other diseases. It tends to be less morphologically altered than in most of the diseases where the two layers are more widely separated. Transient arachnoid alterations during CSF collection are sometimes seen, especially around the pericranium. They can also be seen in the subarachnoid space of the central nervous system and are most likely related to the mechanism of CSF collection. d2c66b5586