Cerebrospinal fluid findings in 108 Japanese cases of herpes simplex encephalitis
Kamei, S.; Takasu, T.; Otani, S.; Mochizuki, Y.
Rinsho Shinkeigaku 29(2): 131-137
1989
ISSN/ISBN: 0009-918X PMID: 2752637 Document Number: 329098
Cerebrospinal fluid (CSF) findings were evaluated in 108 Japanese cases of herpes simplex encephalitis (HSE). The diagnosis was based on clinical, neurodiagnostic and serological examinations. The maximum abnormal values for opening pressure, red blood cell number, total protein concentration, white blood cell number and percentage of polymorphonuclear cell recorded in each case throughout the course of the illness were distributed widely in the range of 80 to 450 mm CSF, 0 to 20,700/cu mm, 15 to 1,390 mg/dl, 0 to 1,089/cu mm and 0 to 85%, respectively. Xanthochromia was revealed in CSF in 30 out of 101 HSE cases (30%), in 21 of which the xanthochromia was independent of traumatic bleeding during the punctures. The frequency of high density lesion in brain computed X-ray tomography was 43% (9 out of 21) in patients with xanthochromia. On the other hand, it was only 7% (7 out of 71) in patients without xanthochromia. This difference was statistically significant (p less than 0.01). The main cause for xanthochromia was considered to be an escape of red blood cell from the hemorrhagic necrotizing lesion to CSF in 14% of cases, the elevation of protein in CSF in 9% and both in 29%. Red blood cell was revealed in CSF in 24 out of 61 HSE cases (40%). The number of cases with more than 51 red blood cells/cu mm was 5 out of 10 patients with xanthochromia compared with only 8 out of 50 without xanthochromia. This difference was statistically significant (p less than 0.05).