Bilirubin in CSF 

It is crucially important to detect subarachnoid haemorrhage ( SAH ) in all patients in whom it has occurred to select patients for angiography and preventative surgery.

It is crucially important to detect subarachnoid haemorrhage ( SAH ) in all patients in whom it has occurred to select patients for angiography and preventative surgery. A computerized tomography ( CT ) scan is positive in up to 98% of patients with SAH presenting within 12 hours, but is positive in only 50% of those presenting within one week.

Cerebrospinal fluid ( CSF ) bilirubin spectrophotometry can be used to determine the need for angiography in those few CT-negative patients in whom clinical suspicion of a SAH remains high; it may remain positive up to two weeks after the event. A lumbar puncture (LP) should only be performed > 12 hours after the onset of presenting symptoms. Whenever possible collect sequential specimens. Always ensure that the least blood-stained CSF sample taken (usually the last) is sent for bilirubin analysis. Protect the CSF from light and avoid vacuum tube transport systems, if possible. Always use spectrophotometry in preference to visual inspection. All CSF specimens are precious and should always be analysed unless an insufficient sample is received. Centrifuge the specimen at >2000rpm for 5 min as soon as possible after receipt in the laboratory. Store the supernatant at 4oin the dark until analysis. An increase in CSF bilirubin is the key finding, which supports the occurrence of SAH but is not specific for this. In most positive cases, bilirubin will occur with oxyhaemoglobin.

Ann Clin Biochem 2008; 45: 238-244. DOI: 10.1258/acb.2008.007257

UV/Vis spectrophotometry scans of CSF xanthochromia although the recommended technique can be difficult to interpret. The trace produced requires the user to manually draw a tangent between two points. This in many cases can be very subjective and offers the potential for introducing calculation errors.

NorthStar Scientific offer the BIO-C system for the analysis of bilirubin xanthochromia in CSF. This comprises a BIO-UV double beam UV/Vis spectrophotometer together with fully automatic data analysis software. The BIO-C software follows the Revised National Guidelines for analysis of CSF for bilirubin in suspected SAH. Calculations are performed and a report is produced.

NEW – Bio-C Version 8 software in combination with our BIO-UV spectrophotometer offers the biochemistry laboratory a simple, assured means of measuring bilirubin xanthochromia in CSF

Bilirubin in CSF
Bilirubin in CSF
Bilirubin in CSF

Key features include of BIO-C V8

Software Request

A 30 day trial copy of the latest version of the BIO-C software can be e-mailed on request. Please make your request for the software on our contacts page.

We also provide on-site demonstrations of the system. This is by far the best option for understanding how the instrument functions. Let us know on the contacts page and we’ll be pleased to help.

The BIO-C system is developed to automate the measurement of CSF xanthochromia. It also enables the measurement of total urine porphyrin, faecal porphyrin, porphobilinogen PBG and 5-Aminolevulinic acid ALA.

Beamont Hospital
Stoke Mandeville Hospital

Data Sheets

The main features of the Bio-C software application are detailed on a datasheet. This is in a pdf format. In order to view this file you need to have Adobe Reader installed on you PC.