Lumbar puncture in a 55-year-old man with progressive leg weakness yields CSF that is yellowish, has a protein of 900 mg/dL, and clots in the tube within minutes. Cell count is 4/µL and glucose is normal. These findings indicate:

• A Subarachnoid hemorrhage three days ago
• B Guillain-Barre syndrome with albuminocytologic dissociation
• C Pyogenic meningitis with high neutrophil lysate content
• D Complete spinal subarachnoid block above the puncture site ✓

Explanation

Xanthochromia with very high protein and spontaneous clotting of the sample constitutes Froin syndrome, produced by stagnation of CSF below a complete block such as an epidural tumor or Pott spine. Subarachnoid hemorrhage gives xanthochromia from bilirubin but not massive protein or clotting, pyogenic meningitis shows pleocytosis and low glucose, and Guillain-Barre raises protein modestly without xanthochromia or clotting.

Reference: Adams and Victor's Principles of Neurology, 11th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.