LABORATORY FINDINGS OF ROUTINE CEREBROSPINAL FLUID ANALYSIS

S. Imayaval, Dr. E. Muthuvel

Abstract


INTRODUCTION:
The cerebrospinal fluid is a dynamic metabolically active substance. Cerebrospinal fluid analysis is used to diagnose the
diseases affecting brain, its coverings and spinal cord. It may be due to infection, inflammation or non infectious causes. A series of laboratory
tests is done on a sample of CSF. It is a clear fluid that provides cushion to the brain. It also delivers nutrients to central nervous system. Central
nervous system includes brain and spinal cord. CSF is produced by the choroid plexus and reabsorbed into brain .Different variables from routine
analysis should be combined in order to arrive at a diagnosis. It includes colour, volume, appearance, cell count, protein, sugar, microbiological
findings and others. These values when combined together will increase the diagnostic sensitivity.
MATERIALS AND METHODS:
This is a retrospective study, results of routine CSF analysis are collected from pathology, biochemistry and microbiology laboratories. The
following criteria are taken into consideration.
COLOUR: With the help of colour changes we may not be able to arrive at diagnosis but it may be useful in identifying the additional
substances in CSF.
TURBIDITY: When the CSF is found to be turbid or cloudy ,there may be white or red blood cells, micro organisms or increase in protein
values.
CELL COUNT: Cytological examination should be carried out within 2 hours after puncture because there will be lysis of RBC and WBC.
CHEMICAL TEST: CSF glucose-It is about 50-60% of blood glucose[9].The levels get decreased when any abnormal cells are present
because these cells will utilize the glucose present.
CSF protein-Usually only a small quantity of proteins are present . High protein values are significant.
MICROSCOPIC EXAMINATION: In a normal CSF ,there will be very less or no cells .In case of more than 5 cells, the laboratories will
definitely perform differential count.
MICROBIOLOGY: The samples are cultured in blood agar,chocolate agar and Mc conkey agar.
CONCLUSION:The age and gender co-relation for 56 cases taking into consideration all the samples irrespective of clinical diagnosis was
determined. Results showed a male predominance. Of the 56 samples, 13 were Neutrophil predominance including degenerated neutrophills
which will be useful in initial diagnosis.In my study, two new borns had protein values 17 and 11 mg and were clinically diagnosed as seizure
disorder.13 samples had increase in protein value.6 samples had low CSF glucose values which were diagnosed as pneumococcal meningitis,
hydrocephalus, seizure, TB meningitis, meningioencephalitis. Gram negative cocci was found in one sample which was diagnosed clinically as
post OP ( 24 hr culture).Gram positive bacilli was found in another sample which was diagnosed clinically as febrile illness, seizure


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