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CSF

The document discusses cerebrospinal fluid (CSF) examination, including specimen collection through lumbar puncture, and analysis of opening pressure, total cell count and differential, glucose, and protein levels. CSF is produced by the choroid plexuses at a rate of around 500mL per day and serves to protect, nourish, and remove waste from the brain and spinal cord. Abnormal results can indicate conditions like meningitis, hemorrhage, or tumors.

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Braha Vaid
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168 views21 pages

CSF

The document discusses cerebrospinal fluid (CSF) examination, including specimen collection through lumbar puncture, and analysis of opening pressure, total cell count and differential, glucose, and protein levels. CSF is produced by the choroid plexuses at a rate of around 500mL per day and serves to protect, nourish, and remove waste from the brain and spinal cord. Abnormal results can indicate conditions like meningitis, hemorrhage, or tumors.

Uploaded by

Braha Vaid
Copyright
© Attribution Non-Commercial (BY-NC)
We take content rights seriously. If you suspect this is your content, claim it here.
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Download as PPT, PDF, TXT or read online on Scribd
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CEREBROSPINAL FLUID EXAMINATION

Institute of Diagnostics Zhong Ning Email: [email protected]

CONTENT
Preface Specimen Collection Opening Pressure Total cell count Differential cell count Glucose Protein
Medicine School of Shandong University 2

2005-5-17

Preface
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).
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The blood-brain barrier


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.

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Medicine School of Shandong University

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Medicine School of Shandong University

Specimen Collection
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.
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Opening Pressure
Normal opening pressure in adults is 90~180mmH2O, 10~100mmH2O in children.

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Elevated pressure
Congestive heart failure Meningitis Superior vena cava syndrome Cerebral edema Mass lesion

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Decreased pressure
Spinal-subarachnoid block Dehydration Circulatory collapse CSF leakage

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Total cell count & DC


The normal leukocyte cell count in adults is 0~5 cells/ul. Increased neutrophils:
Bacterial Meningitis cerebral abscess subdural empyema CNS hemorrhage CNS infarct

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Increase Lymphocytes: Viral meningitis Multiple sclerosis

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Glucose
The normal Glucose is about 60% compared to serum level. Normal 50~80mg/dl Elevated Glucose: Diabetes mellitus, DM Decreased Glucose: Bacterial Meningitis

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Total Protein
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.

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Elevated CSF protein


Reason Increased permeability of the blood-brain barrier. Decreased resorption Mechanical obstruction of CSF flow

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Elevated CSF protein


Arachnoiditis Meningitis Hemorrhage Endocrine/Metabolic disorders

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