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    CSF Analysis

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    EB
    Cerebrospinal fluid is produced in the ventricles and circulates through the subarachnoid space. It is reabsorbed in the arachnoid villi. A lumbar puncture can be used diagnostically to check for conditions like meningitis or subarachnoid hemorrhage, and therapeutically to relieve increased intracranial pressure. During the procedure, CSF is collected and analyzed for pressure, appearance, and cell count to check for abnormalities that could indicate different conditions.

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    CSF Analysis

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    EB
    114 views20 pages
    Cerebrospinal fluid is produced in the ventricles and circulates through the subarachnoid space. It is reabsorbed in the arachnoid villi. A lumbar puncture can be used diagnostically to check for conditions like meningitis or subarachnoid hemorrhage, and therapeutically to relieve increased intracranial pressure. During the procedure, CSF is collected and analyzed for pressure, appearance, and cell count to check for abnormalities that could indicate different conditions.

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    Cerebrospinal fluid is produced in the ventricles and circulates through the subarachnoid space. It is reabsorbed in the arachnoid villi. A lumbar puncture can be used diagnostically to check for conditions like meningitis or subarachnoid hemorrhage, and therapeutically to relieve increased intracranial pressure. During the procedure, CSF is collected and analyzed for pressure, appearance, and cell count to check for abnormalities that could indicate different conditions.

    Copyright:

    © All Rights Reserved
    Download as PPTX, PDF, TXT or read online from Scribd
    Download as pptx, pdf, or txt
    114 views20 pages

    CSF Analysis

    Uploaded by

    EB
    Cerebrospinal fluid is produced in the ventricles and circulates through the subarachnoid space. It is reabsorbed in the arachnoid villi. A lumbar puncture can be used diagnostically to check for conditions like meningitis or subarachnoid hemorrhage, and therapeutically to relieve increased intracranial pressure. During the procedure, CSF is collected and analyzed for pressure, appearance, and cell count to check for abnormalities that could indicate different conditions.

    Copyright:

    © All Rights Reserved
    Download as PPTX, PDF, TXT or read online from Scribd
    Download as pptx, pdf, or txt
    of 20

    CSF ANALYSIS

    PHYSIOLOGY
    Cerebrospinal fluid (CSF) is produced by

    the choroid plexus in the lateral, third, and


    fourth ventricles and

    circulates through the subarachnoid space


    between the arachnoid mater.
    • CSF is
    reabsorbed in the arachnoid villi, located along
    the superior sagittal and intracranial venous
    sinuses and around the spinal nerve roots.
    CHARACTERISTICS
    •  Normal cerebrospinal fluid (CSF) is clear and
    colorless.
    •
    • The normal CSF pressure as measured with a
    manometer in a patient lying flat in the lateral
    decubitus position is between 60 and 180 mmH20 

    • The CSF volume is 125 to 150 mL; approximately 20


    percent of the CSF is contained in the ventricles
    and the pia mater.
    LUMBAR PUNCTURE
    INDICATIONS

    DIAGNOSTIC THERAPEUTIC
    Indications for lumbar puncture
    • Suspicion of meningitis
    • Suspicion of subarachnoid hemorrhage
    • Suspicion of central nervous system diseases
    such as Guillain-Barré syndrome and
    carcinomatous meningitis
    • Therapeutic relief of pseudotumor cerebri
    • Injection of drugs and anesthetics
    Contra Indications of lumbar punctures

    • Increased intracranial pressure (ICP) of and unidentified origin


    - Can cause cerebral herniation
    - Exception: therapeutic use of lumbar puncture to reduce ICP
    • Infections
    - Skin infections at puncture site may cause sepsis
    • Abnormal respiratory pattern
    -Hypertension with bradycardia and deteriorating consciousness
    -Vertebral deformities (scoliosis or kyphosis), in hands of an
    inexperienced physician.
    • Bleeding diathesis
    -Coagulopathy
    -Decreased platelet count (<50 x 109/L)
    PROCEDURE
    Lumbar puncture
    • The patient is placed in a lateral position with the
    knees bent in full flexion up to the chest(fetal position)
    (sit and bend position also possible)
    • Introduction of 1% lidocain into the subcutaneous
    space
    • Insertion of a spinal needle into the subarachnoid
    space at the L3-L4 or L4-L5 intercostal spaces (inserted
    until the second “give”- subarachnoidal space).
    • Removal of the stylet of the needle in order to collect
    the fluid
    CSF analysis - Pressure
    • Measured with a column manometer (fetal position is
    optimal)
    • Increased pressure: congestive heart failure, cerebral
    edema, subarachnoid hemorrhage, hypo-osmolality
    resulting from hemodialysis, purulent or tuberculous
    meningitis, hydrocephalus, or pseudotumor cerebri.
    • Decreased pressure: complete subarachnoid blockage,
    leakage of spinal fluid, severe dehydration,
    hyperosmolality, or circulatory collapse
    • Xanthochromia — Normal cerebrospinal fluid (CSF) is
    clear and colorless.
    • Both infectious and noninfectious processes can alter
    the appearance of the CSF.
    • As few as 200 white blood cells (WBCs) or 400 red
    blood cells (RBCs)/microL will cause CSF to appear
    turbid
    • The breakdown of hemoglobin first to oxyhemoglobin
    (pink) and later to bilirubin (yellow) leads to a yellow or
    pink discoloration of the CSF known as xanthochromia.
    • Cells — The CSF is normally acellular.
    • However, up to 5 WBCs and 5 RBCs are considered
    normal in adults when the CSF is sampled by lumbar
    puncture (LP).
    • . 
    CSF analysis- cell count
    99% of patients with bacterial meningitis have >100
    WBC’s/mm (less than that is only common for viral
    meningitis)
    Viral meningitis: predominance of lymphocytes T
    Bacterial meningitis: predominance of PMN’s
    Fungal and tubercular meningitis: predominance of
    lymphocytes and high content of proteins, decrased
    glucose
    RBC’s: abnormal finding(be careful with traumatic taps,
    3 samples are needed)

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