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Cerebrospinal Fluid Analysis

Cerebrospinal Fluid Analysis is a topic covered in the Davis's Lab & Diagnostic Tests.

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CSF analysis (lumbar puncture, spinal tap).

Common Use:
To assist in the differential diagnosis of infection or hemorrhage of the brain. Also used in the evaluation of other conditions with significant neuromuscular effects, such as multiple sclerosis.

Cerebrospinal fluid (CSF) collected in three or four separate plastic conical tubes. Tube 1 is used for chemistry and serology testing, tube 2 is used for microbiology, tube 3 is used for cell count, and tube 4 is used for miscellaneous testing.

Normal Findings:
(Method: Macroscopic evaluation of appearance; spectrophotometry for glucose, lactic acid, and protein; immunoassay for myelin basic protein; nephelometry for immunoglobulin G [IgG]; electrophoresis for oligoclonal banding; Gram stain, India ink preparation, and culture or PCR for microbiology; microscopic examination of fluid for cell count; flocculation for Venereal Disease Research Laboratory [VDRL])

Lumbar PunctureConventional UnitsSI Units
Color and appearanceCrystal clear
(Conventional Units × 10)
 0–1 moLess than 150 mg/dLLess than 1,500 mg/L
 1–6 mo30–100 mg/dL300–1,000 mg/L
 7 mo–adult15–45 mg/dL150–450 mg/L
 Older adult15–60 mg/dL150–600 mg/L
(Conventional Units × 0.0555)
 Infant or child60–80 mg/dL3.3–4.4 mmol/L
 Adult/older adult40–70 mg/dL2.2–3.9 mmol/L
(Conventional Units × 0.111)
Lactic acid
 Neonate10–60 mg/dL1.1–6.7 mmol/L
 3–10 d10–40 mg/dL1.1–4.4 mmol/L
 AdultLess than 25.2 mg/dLLess than 2.8 mmol/L
(Conventional Units × 1)
Myelin basic protein
Less than 4 ng/mLLess than 4 mcg/L
Oligoclonal bandsAbsent
(Conventional Units × 10)
IgGLess than 3.4 mg/dLLess than 34 mg/L
Gram stainNegative
India inkNegative
CultureNo growth
RBC count00
(Conventional Units × 1)
WBC count
Neonate–1 mo0–30 /microL0–30 × 106/L
 1 mo–1 yr0–10 /microL0–10 × 106/L
 1–5 yr0–8 /microL0–8 × 106/L
 5 yr–adult0–5 /microL0–5 × 106/L
CytologyNo abnormal cells seen
CSF glucose should be 60%–70% of plasma glucose level.RBC = red blood cell; VDRL = Venereal Disease Research Laboratory; WBC = white blood cell.Color should be assessed after sample is centrifuged.
WBC DifferentialAdultChildren

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Bladh, Mickey Lynn., and Anne M. Van Leeuwen. "Cerebrospinal Fluid Analysis." Davis's Lab & Diagnostic Tests, 7th ed., F.A. Davis Company, 2017. Nursing Central, nursing.unboundmedicine.com/nursingcentral/view/Davis-Lab-and-Diagnostic-Tests/425255/all/Cerebrospinal_Fluid_Analysis.
Bladh ML, Van Leeuwen AM. Cerebrospinal Fluid Analysis. Davis's Lab & Diagnostic Tests. 7th ed. F.A. Davis Company; 2017. https://nursing.unboundmedicine.com/nursingcentral/view/Davis-Lab-and-Diagnostic-Tests/425255/all/Cerebrospinal_Fluid_Analysis. Accessed April 24, 2019.
Bladh, M. L., & Van Leeuwen, A. M. (2017). Cerebrospinal Fluid Analysis. In Davis's Lab & Diagnostic Tests. Available from https://nursing.unboundmedicine.com/nursingcentral/view/Davis-Lab-and-Diagnostic-Tests/425255/all/Cerebrospinal_Fluid_Analysis
Bladh ML, Van Leeuwen AM. Cerebrospinal Fluid Analysis [Internet]. In: Davis's Lab & Diagnostic Tests. F.A. Davis Company; 2017. [cited 2019 April 24]. Available from: https://nursing.unboundmedicine.com/nursingcentral/view/Davis-Lab-and-Diagnostic-Tests/425255/all/Cerebrospinal_Fluid_Analysis.
* Article titles in AMA citation format should be in sentence-case
TY - ELEC T1 - Cerebrospinal Fluid Analysis ID - 425255 A1 - Bladh,Mickey Lynn, AU - Van Leeuwen,Anne M, BT - Davis's Laboratory & Diagnostic Tests UR - https://nursing.unboundmedicine.com/nursingcentral/view/Davis-Lab-and-Diagnostic-Tests/425255/all/Cerebrospinal_Fluid_Analysis PB - F.A. Davis Company ET - 7 DB - Nursing Central DP - Unbound Medicine ER -