THE GLUCOSE concentration in cerebrospinal fluid (CSF) is frequently not determined in cases of uncomplicated subarachnoid hemorrhage, perhaps on the assumption that it adds little to diagnosis. Indeed, many standard references do not even include subarachnoid hemorrhage as a cause of hypoglycorrhachia.1-7
Primary meningeal diseases, such as the granulomatous meningitides or meningeal carcinomatosis, may on occasion cause bleeding into the subarachnoid space. It might be thought that the level of CSF glucose would help in distinguishing these processes from primary subarachnoid hemorrhage. We present four cases of subarachnoid hemorrhage, uncomplicated by infection or neoplasm, in which CSF glucose value was markedly decreased.
Report of Cases
CASE 1 (CGH 263191).—A 26-year-old white man was admitted to Colorado General Hospital for evaluation of severe constant headache and increasing drowsiness. The patient had awakened with a mild headache eight days previously. The headache became progressively more severe and he was seen