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Dr. Andrew Rynne
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Dr. Andrew Rynne

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Article Home First Aid and Emergency Interpretation of cerebrospinal fluid (CSF) analysis in neurological conditions

Interpretation of cerebrospinal fluid (CSF) analysis in neurological conditions

Many neurological conditions may affect the brain. They maybe be diagnosed by different methods. One of the methods is CSF analysis which can help different between infection or bleeding in the brain.

Cerebrospinal fluid is a clear fluid circulation in and around the brain, spine and meninges. It helps supply nutrients and remove waste materials like amino acids etc. The composition of CSF is maintained by many mechanisms. Many diseases, especially infections can alter the constitution of CSF. Normal constitution of CSF is given below:

Parameter

Normal Range

Opening pressure

7-18

Appearance

Clear, colorless

Protein (mg/Dl)

23-38

Glucose (mmol/L)

2/3rds serum glucose

Gram stain

Negative

White cell count

<5 cells

 

When a person is affected by brain infection, it can change the values of parameters of CSF. CSF is withdrawn by lumbar puncture to check for the type of infection. Treatment depends on the results of this CSF analysis.

Parameter

Normal Range

Viral CNS Infection

Bacterial CNS infection

Opening pressure

7-18

Normal or mildly increased

>30

Appearance

Clear, colorless

Clear

Turbid

Protein (mg/Dl)

23-38

Normal to decreased

Increased

Glucose (mmol/L)

2/3rds serum glucose

Normal

Decreased

Gram stain

Negative

Negative

Positive in 61% cases

White cell count

<5 cells

Lymphocytes raised

Neutrophils raised

 

 

If red blood cells ae seen in CSF, it is suggestive of bleeding (e.g subarachnoid hemorhage) or HSV  encephalitis. Further microbiological tests will confirm the type of infection e. g PCR can confirm the type of infection.

Written by Dr Vaishalee Punj

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