IS A LOW CEREBROSPINAL-FLUID BLOOD-GLUCOSE RATIO INDICATIVE OF INFECTION IN PATIENTS WITH POST HEMORRHAGIC HYDROCEPHALUS

Cerebrospinal fluid glucose and cerebrospinal fluid:blood glucose rati os were compared in seven patients with post haemorrhagic hydrocephalu s having lumbar puncture/ventricular tap as a therapeutic measure. A c ontrol group of 10 babies was used, without intraventricular haemorrha ge, and having lumbar puncture as part of a septic screen. Of 50 separ ate taps in the patient group, 38% had blood glucose measured and 76% had CSF glucose measured. Median cerebrospinal fluid glucose was 1.2 m mol (range, 0.4-2.5 mmol/l) in the patient group and 3.1 mmol/l (range , 1.4-10.3 mmol/l) in the control group. The median cerebrospinal flui d:blood glucose ratio in the patient group was 0.235 (range, 0.07-0.53 ) and in the control group was 0.709 (range, 0.6-1.4). Hypoglycorrhach ia appears to be a normal finding in patients with post haemorrhagic h ydrocephalus and does not indicate infection in these infants. Measure ment of cerebrospinal fluid:blood glucose ratio is not warranted when cerebrospinal fluid is drained purely as a therapeutic measure in thes e patients.