Cerebrospinal Fluid Analysis

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

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General

Synonym/Acronym:
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.

Specimen:
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)
Protein
 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)
Glucose
 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
VDRLNonreactive
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
Lymphocytes40%–80%5%–13%
Monocytes15%–45%50%–90%
Neutrophils0%–6%0%–8%

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Citation

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TY - ELEC T1 - Cerebrospinal Fluid Analysis ID - 425255 Y1 - 2017 PB - Davis's Laboratory & Diagnostic Tests UR - https://nursing.unboundmedicine.com/nursingcentral/view/Davis-Lab-and-Diagnostic-Tests/425255/all/Cerebrospinal_Fluid_Analysis ER -