Author Affiliations: Department of Neurology, Hôpitaux Civils de Colmar, Colmar, France.
We read the article by Vale et al1 about idiopathic superficial siderosis with great interest. The authors pointed out that this syndrome may still be missed on magnetic resonance imaging as the imaging abnormalities follow the contours of the brain and can be overlooked. They also stated that “xanthochromia or the presence of red blood cells (RBC) in the [cerebrospinal fluid] CSF is a common finding and may be due to damage to a small blood vessel during the procedure (known as a ‘traumatic tap’).” Whereas the presence of red blood cells may indeed be the consequence of a traumatic spinal tap, xanthochromia necessarily witnesses a bleeding that occurred earlier than the spinal tap.
Sellal F, Ahle G. Superficial Siderosis, Traumatic Tap, and Xanthochromia. Arch Neurol. 2012;69(6):791-792. doi:10.1001/archneurol.2012.132