Yellow cerebrospinal fluid flow during spinal anesthesia: a case report

Abstract

When a spinal needle enters the subarachnoid space after dural puncture, a clear cerebrospinal fluid (CSF) emerges. If the color of the CSF is not clear, it is necessary to rule out the cause of such a change including subarachnoid hemorrhage (SAH). Here, we report a case of a seventy-nine-year-old female, to whom we initially attempted spinal anesthesia but converted to general anesthesia due to yellow CSF. Unlike normal colorless CSF, yellowish CSF is called xanthochromia. Xanthochromia may result from various causes such as blood, bilirubin, and protein in CSF. We suggest against to proceeding with spinal anesthesia in patients with xanthochromia because it is difficult to differentiate the exact cause without appropriate CSF analysis at the moment.