Session:

Diagnostics

Abstract No.:

55.007

Title:

Osmolality of  CSF in inflammatory diseases of central nervous system

Author(s):

B. Dupanović, B. Andrić, D. Terzic; Clinic for Infectious Diseases, University of Montenegro, Faculty of Medicine, Podgorica, Podgorica/ME

Abstract:

Background: Diseases of the central nervous system (CNS) still represent a significant medical problem. Diagnosed in a timely manner is an essential condition for a favorable course and outcome of disease. Osmolality of serum and cerebrospinal fluid (CSF) change in various CNS diseases can be important for early and differential diagnosis. 
Methods: A prospective study sample (n=160) distributed according the etiology in 8 groups: 1. Purulent bacterial encephalitis (PBE), 2. Purulent meningitis (PM), 3. Tuberculous meningitis (TM), 4. Viral encephalitis (VE), 5. Viral meningitis (VM ), 6. Neurological disease (N: Guillain–Barré syndrome, multiple sclerosis)  7. Neurosurgical disease (NS: subarachnoid hemorrhage, brain tumors), 8. Meningismus (M: control group). The outcome of the disease were divided into 3 groups: healed, recovered and deaths. Osmolality of plasma and CSF were determined by osmometry in regard to the freezing-point depression.
Results: The average age of the examined sample of patients was 33.42 years +/- 21.19. 53.2% males and 46.8% females. Observing outcome showed cure in 60% of patients, 20.2% were recovered patients and 19.8% died. Determined mean value of blood osmolality and CSF in patients with PBE (282.95, 281.35 mOsm/kg), PM (282.75, 279.75 mOsm/kg), TM (274.85, 271.35 mOsm/kg), VE (282.50, 278.95 mOsm/kg), VM (284.50, 284.90 mOsm/kg), N (285.10, 290.35 mOsm/kg), NS (286.95, 288.45 mOsm/kg). M (291.40 mOsm/kg). Osmolality of blood / CSF in deaths were: in PBE 280.33/279.17 mOsm/kg, in PM 290.00/283.50 mOsm/kg, in TM 269.67/259.00 mOsm/kg; in VE 274.83/271.50 mOsm/kg, in N 281.50/291.50 mOsm/kg, in NS 287.45/289.82 mOsm/kg.
Conclusion: There is no significance in the gender distribution among the examined groups (p> 0.05). There is a high difference in the values ​​of osmolality in serum and CSF of patients between groups (p <0.001).) Osmolality values ​​of blood and CSF were highest in the control group and lowest in the group of patients with bacterial infections of the CNS. There was a significant correlation between blood osmolality and CSF patients in all groups ANOVA (p <0.001).) In VE patients is found a significant correlation between the osmolality of blood and CSF osmolality in relation to the outcome of the disease (p <0.005). Patients with lower values ​​had worse outcome.