Cerebrospinal fluid ( CSF)
It is the fluid that occupies the spaces of the C.N.S, it circulates upward over the cerebral hemispheres and downward over the spinal cord and nerve roots.
Formation:-
70% by the ventricular choroid plexus and 30% by epindymal lining of the ventricles as well as cerebral and arachinoid space. Its normal adult volume is 100-200 ml. It functions as an excretory vehicle, circulate nutrients and lubricates CNS.
Function.
C.S.F. examination:-
C.S.F is obtained by lumbar puncture, lateral cervical puncture or through ventricular cannula or shunts under aseptic conditions. Indications for C.S.F examination are meningeal infection, subarachinoid hemorrhage, CNS malignancy and demylinating diseases .
Appearance: -
Normal C.S.F is clear, colorless, clot free and has the viscosity of water. Turbidity in fresh CSF may be due to erythrocytes, leukocytes or bacteria. Colored CSF is due to oxy- hemoglobin, bilirubin or drugs. Bloody CSF sample may be due to a traumatic tap (clear supernatant after centrifugation) or hemorrhage (yellow supernatant, xanthochromia). Clot formation may be due to its traumatic tap, complete spinal block (Froin`s syndrome) and suppurative or T.B meningitis.
Chemical examination:-
Total protein (normal range 20 – 40 mg/dl): -
Increased CSF proteins occur in diseases of the CNS, general toxic states as uremia, acute meningitis, below spinal block and traumatic tap and myelomatosis. Increased levels of IgG CSF protein may be derived from either diffusion across blood CSF barrier or increased synthesis. As albumin is not produced by CNS, so CSF/plasma albumin ratio reflect the functional integrity of the barrier.
Decrease in CSF protein occur due to leakage of CSF, removal of large amount of CSF during radiographic technique, increased intracranial pressure and hyperthyroidism.
Glucose (normal CSF level 40-80 mg/dl):-
Increased level (relative to plasma glucose) is an evidence of hyperglycemia 2-4 hour prior to lumbar puncture. Decreased level of CSF glucose < style="text-align: center;">
Formation:-
70% by the ventricular choroid plexus and 30% by epindymal lining of the ventricles as well as cerebral and arachinoid space. Its normal adult volume is 100-200 ml. It functions as an excretory vehicle, circulate nutrients and lubricates CNS.
Function.
C.S.F. examination:-
C.S.F is obtained by lumbar puncture, lateral cervical puncture or through ventricular cannula or shunts under aseptic conditions. Indications for C.S.F examination are meningeal infection, subarachinoid hemorrhage, CNS malignancy and demylinating diseases .
Appearance: -
Normal C.S.F is clear, colorless, clot free and has the viscosity of water. Turbidity in fresh CSF may be due to erythrocytes, leukocytes or bacteria. Colored CSF is due to oxy- hemoglobin, bilirubin or drugs. Bloody CSF sample may be due to a traumatic tap (clear supernatant after centrifugation) or hemorrhage (yellow supernatant, xanthochromia). Clot formation may be due to its traumatic tap, complete spinal block (Froin`s syndrome) and suppurative or T.B meningitis.
Chemical examination:-
Total protein (normal range 20 – 40 mg/dl): -
Increased CSF proteins occur in diseases of the CNS, general toxic states as uremia, acute meningitis, below spinal block and traumatic tap and myelomatosis. Increased levels of IgG CSF protein may be derived from either diffusion across blood CSF barrier or increased synthesis. As albumin is not produced by CNS, so CSF/plasma albumin ratio reflect the functional integrity of the barrier.
Decrease in CSF protein occur due to leakage of CSF, removal of large amount of CSF during radiographic technique, increased intracranial pressure and hyperthyroidism.
Glucose (normal CSF level 40-80 mg/dl):-
Increased level (relative to plasma glucose) is an evidence of hyperglycemia 2-4 hour prior to lumbar puncture. Decreased level of CSF glucose < style="text-align: center;">
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