Evidence map›Paper›PMID 40486425›Full record

ArticleCureus2025

A Red Herring in the Cerebrospinal Fluid: Xanthochromia Due to Mixed Etiology in the Absence of Subarachnoid Hemorrhage.

Neville Shery, Rafid Mustafa, Mohammed Al-Hamas

Abstract readCase Reports
In one paragraph

Article in Cureus, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

3 authors.

Neville SheryGeneral Medicine, Pilgrim Hospital, Boston, GBR.
Rafid MustafaAcute Medicine, Pilgrim Hospital, Boston, GBR.
Mohammed Al-HamasAcute Internal Medicine, Pilgrim Hospital, Boston, GBR.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Xanthochromia in cerebrospinal fluid (CSF) is most commonly associated with subarachnoid hemorrhage (SAH), but other etiologies must be considered when initial imaging is unremarkable. We present the case of a 50-year-old woman with a sudden, severe headache. Computed tomography (CT) of the head was normal, but lumbar puncture revealed xanthochromia, elevated CSF protein (139.5 mg/dL), and no red or white blood cells. Varicella zoster virus (VZV) was detected by CSF polymerase chain reaction (PCR), and MRI demonstrated chronic cervicomedullary stenosis without evidence of hemorrhage or encephalitis. The patient was treated empirically with intravenous acyclovir and fully recovered. The findings suggest a mixed etiology for xanthochromia involving partial mechanical obstruction of CSF flow and a subclinical viral process. This case highlights the importance of considering infectious, inflammatory, and structural causes in the differential diagnosis of xanthochromia when SAH is excluded.

Indexed as

acute subarachnoid haemorrhagecerebrospinal fluid (csf)headache medicinevaricella encephalitisxanthochromia

Identifiers

PMID40486425
PMCPMC12144623

What OpenQuestion holds

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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.