What question did this study set out to answer?

To report the occurrence of milky cerebrospinal fluid (CSF) during endoscopic hematoma removal, with focus on triglyceride levels.

February 26, 2026Journal of Neurosurgery Case Lessons0 citations

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Milky cerebrospinal fluid without infection during endoscopic hematoma removal: illustrative case

KSKoji Saito HKHirokazu Koseki THTatsuya Hirotsu

Key Points

To report the occurrence of milky cerebrospinal fluid (CSF) during endoscopic hematoma removal, with focus on triglyceride levels.
Endoscopic surgical procedure for hematoma removal was performed.
Intraoperative video was recorded to document observations of CSF appearance.
Triglyceride levels in the CSF were inferred based on molecular weight considerations.
Milky CSF was observed during the procedure.
High concentrations of triglycerides during the surgery led to the milky appearance.
This case is the first documented instance of milky CSF in an endoscopic hematoma operation.

Abstract

Because of their molecular weight, TGs cannot penetrate the blood-brain barrier. Therefore, milky CSF is suspected to be caused by high concentrations of TGs eluted from the hematoma. This is the first case report of milky CSF observed using an intraoperative video of endoscopic surgery. https://thejns.org/doi/10.3171/CASE25701.

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Cite This Study

Saito et al. (Mon,) studied this question.

synapsesocial.com/papers/699fe24b95ddcd3a253e6291 https://doi.org/https://doi.org/10.3171/case25701

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