General
Synonym/Acronym:
CSF analysis.
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:
CSF (1 to 3 mL) 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 for microbiology; microscopic examination of fluid for cell count; flocculation for Venereal Disease Research Laboratory [VDRL])
| Lumbar Puncture | Conventional Units | SI Units |
|---|
| Color and appearance | Crystal clear | |
| (Conventional Units × 10) |
| Protein | | |
| 0–1 mo | Less than 150 mg/dL | Less than 1,500 mg/L |
| 1–6 mo | 30–100 mg/dL | 300–1,000 mg/L |
| 7 mo–adult | 15–45 mg/dL | 150–450 mg/L |
| Older adult | 15–60 mg/dL | 150–600 mg/L |
| (Conventional Units × 0.0555) |
| Glucose | | |
| Infant or child | 60–80 mg/dL | 3.3–4.4 mmol/L |
| Adult/older adult | 40–70 mg/dL | 2.2–3.9 mmol/L |
| (Conventional Units × 0.111) |
| Lactic acid | | |
| Neonate | 10–60 mg/dL | 1.1–6.7 mmol/L |
| 3–10 days | 10–40 mg/dL | 1.1–4.4 mmol/L |
| Adult | Less than 25.2 mg/dL | Less than 2.8 mmol/L |
| (Conventional Units × 1) |
| Myelin basic protein | | |
| Less than 4.0 ng/mL | Less than 4.0 mcg/L |
| Oligoclonal bands | Absent | |
| (Conventional Units × 10) |
| IgG | Less than 3.4 mg/dL | Less than 34 mg/L |
| Gram stain | Negative | |
| India ink | Negative | |
| Culture | No growth | |
| RBC count | 0 | 0 |
| (Conventional Units × 1) |
| WBC count | | |
| Neonate–1 mo | 0–30 cells/mm3 | 0–30 × 109/L |
| 1 mo–1 yr | 0–10 cells/mm3 | 0–10 × 109/L |
| 1–5 yr | 0–8 cells/mm3 | 0–8 × 109/L |
| 5 yr–adult | 0–5 cells/mm3 | 0–5 × 109/L |
| VDRL | Nonreactive | |
| Cytology | No 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 Differential | Adult | Children |
|---|
| Lymphocytes | 40%–80% | 5%–13% |
| Monocytes | 15%–45% | 50%–90% |
| Neutrophils | 0%–6% | 0%–8% |
Cerebrospinal Fluid Analysis has been found in Davis's Lab & Diagnostic Tests
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