CONTENT - Preface
- Specimen Collection
- Opening Pressure
- Total cell count
- Differential cell count
- Glucose
- Protein
Preface - Medicine School of Shandong University
- Cerebrospinal fluid (CSF) is mostly derived through the choroid plexuses.
- 500mL/day approximately
- CSF protects the brain and spinal cord, and collects waste, circulates nutrients, cushions and lubricates the central nervous system (CNS).
- Medicine School of Shandong University
- Medicine School of Shandong University
- BBB is a concept derived from dye-exclusion studies rather than a specific anatomic structure.
- Certain substances in the CSF are tightly regulated by specific transport systems.
- Medicine School of Shandong University
- Medicine School of Shandong University
Specimen Collection - Medicine School of Shandong University
- Lumbar puncture (LP) is the insertion of a needle into the subarachnoid space (the area under the membrane that surrounds the brain and spinal cord) of the lumbar (lower back) region for diagnostic or therapeutic purposes. This allows access to the cerebrospinal fluid (CSF) in which the brain and spinal cord float.
- Although the subarachnoid space can be accessed from other levels, the lumbar region is most often used as it allows the needle to be inserted below the end of the spinal cord.
- Medicine School of Shandong University
- Medicine School of Shandong University
Opening Pressure - Medicine School of Shandong University
- Normal opening pressure in adults is 90~180mmH2O, 10~100mmH2O in children.
Elevated pressure - Medicine School of Shandong University
- Congestive heart failure
- Meningitis
- Superior vena cava syndrome
- Cerebral edema
- Mass lesion
Decreased pressure - Medicine School of Shandong University
- Spinal-subarachnoid block
- Dehydration
- Circulatory collapse
- CSF leakage
Total cell count & DC - Medicine School of Shandong University
- The normal leukocyte cell count in adults is 0~5 cells/ul.
- Increased neutrophils:
- Bacterial Meningitis
- cerebral abscess
- subdural empyema
- CNS hemorrhage
- CNS infarct
- Medicine School of Shandong University
- Medicine School of Shandong University
- Increase Lymphocytes:
- Viral meningitis
- Multiple sclerosis
Glucose - Medicine School of Shandong University
- The normal Glucose is about 60% compared to serum level.
- Normal 50~80mg/dl
- Elevated Glucose:
- Diabetes mellitus, DM
- Decreased Glucose:
- Bacterial Meningitis
-
Total Protein - Medicine School of Shandong University
- Over 80% of CSF protein content is derived from the plasma.
- An increased CSF protein serves as a useful but nonspecific indicator of disease.
- Normal level 15~45mg/dl.
- Medicine School of Shandong University
- Reason
- Increased permeability of the blood-brain barrier.
- Decreased resorption
- Mechanical obstruction of CSF flow
Elevated CSF protein - Medicine School of Shandong University
- Arachnoiditis
- Meningitis
- Hemorrhage
- Endocrine/Metabolic disorders
- Medicine School of Shandong University
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