What should i ask for in a csf analysis and what is. Biochemical analysis of cerebrospinal fluid in the. Commonly performed tests on csf include protein and glucose levels, cell counts and differential, microscopic examination, and culture. They are also advised to continually check for updated normal ranges. Creatine kinasebb in the cerebrospinal fluid as a marker of cns metastases and leptomeningeal carcinomatosis in patients with breast cancer. Cerebrospinal fluid csf is a clear, watery liquid that flows around the brain and spinal cord, surrounding and protecting them. However, in various neurological disease especially in acute conditions, the composition, quantity and its pressure can be altered. Cerebrospinal fluid cytology and clinical analysis of 34 cases with leptomeningeal carcinomatosis j liu, h jia, y yang, w dai, x suandg zhao department of neurology, xijing hospital of the fourth military medical university, xian city, shaanxi province, china the clinical characteristics and cerebrospinal fluid csf cytological.
Pdf lumbar puncture is frequently performed in primary care. Csf collection guidelines calgary laboratory services. It contains glucose, electrolytes, amino acids, and other small molecules found in plasma, but has very little protein and few cells. Cerebrospinal fluid analysis in the workup of glut1. Brain mri location plaques typically in the periventricular region, corpus callosum, centrum semiovale, and occasionally in deep white matter structures and basal ganglia. Csf is a clear fluid that surrounds and protects the brain and spinal cord. Performing the cytological analysis of the cerebrospinal fluid cfs and enumerating leukocytes and erythrocytes is a routine first step in the laboratory diagnosis of meningitis 1,2,3,4. It is a routine practice to collect three 3 sterile tubes of csf 15 ml per tube for analysis. Infectious diseases such as meningitis and encephalitis testing is used to determine if the cause is bacterial, tuberculous, fungal or viral, and to. To increase the specificity of diagnosis and to minimize the number of false diagnoses, the committee recommended the use of both clinical and paraclinical criteria, the.
Recommended standard of cerebrospinal fluid analysis in. Cerebrospinal fluid csf analysis is a classic tool for diag. A serum glucose analysis should be done simultaneously. Salam, i am a lab technologist, i found this article simple and easily. Standard csf analysis meningitis, meningeal cancer, encephalitis in rapidly progressive dementias none csf analysis for 1433 protein or neuronspecific enolase cjd when cjd is suspected highly sensitive and specific, if acute infections, stroke, and neoplastic diseases are excluded by other means csf analysis for betaamyloid and tau. Cns, such that values double with every 510 ml of csf collected. Cerebrospinal fluid csf analysis procedure, test, blood, tube. A csf analysis is a group of tests that look at your cerebrospinal fluid to help diagnose diseases and conditions that affect the brain and spinal cord. Supplementary material for csf xanthochromia analysis takes longer following centralisation of the laboratories testing samples how can we improve the time to result. Brain mri findings are abnormal in 95% of ms patients. Properly interpreted tests can make cerebrospinal fluid csf a key tool in the. Pancreatic elastase1 this test is used to detect exocrine pancreatic insufficency.
All practitioners are urged to consult the normal laboratory values for their local laboratory, as these may differ from those listed below. Collect at room temperature and send immediately to the microbiology laboratory. Diagnostic workup for patients with suspected demyelinating disease. Cerebrospinal fluid specimens university of colorado. Reports of patients with apparently normal csf glucose levels, however, have raised the question whether csf analysis is a reliable screening tool for glut1 deficiency syndrome. A lumbar puncture, also called a spinal tap, is the. Cerebrospinal fluid analysis in clinical diagnosis. Results interpretation pdf if serum and csf are submitted simultaneously for sarcofluor or neofluor testing, results will also include a serumcsf ratio. Laboratory general specimen collection and handling guidelines page 5 of 49 general lab samplesource.
The asssociation of clinical biochemists in ireland the biochemistry of body fluids version 1. When we think about cerebrospinal fluid csf analysis, it helps to first step back for a historical overview. Importance glut1 deficiency syndrome is a treatable neurometabolic disorder, characterized by a low concentration of glucose in cerebrospinal fluid csf and a decreased csf to blood glucose ratio. Laboratory diagnosis of meningitis 187 contamination with skin flora and disinfectant w ill be ruled out after the first tube of csf is collected.
Its a series of lab tests performed on a sample of csf. Under normal conditions, the composition of csf remains constant. This correction factor is accurate as long as the peripheral wbc count is not extremely high or low. Take csf specimens immediately to the laboratory after collection. A prospective study to determine the value of cerebrospinal fluid analysis in the differential diagnosis of meningitis was performed in 710 consecutively observed patients, both children and. The tests may look for proteins, sugar glucose, and other substances. Cerebrospinal fluid analysis in infectious diseases of the. A csf analysis is a group of tests that evaluate substances in csf in order to diagnose conditions affecting the brain and spinal cord central nervous system. Cerebrospinal fluid csf analysis may be used to help diagnose a wide variety of diseases and conditions affecting the central nervous system cns. Still today, morphologic evaluation in conjunction with chemical analysis and microbiology studies are. Haematology cerebrospinal fluid analysis laboratory.
Csf when examined early in the course of the illness. To ensure the best patient care, if at all possible, csf samples should be submitted in this manner. The blood cells and the offending organisms sought for diagnosis rapidly lyse on standing while the bacteria multiply with delay in analysis resulting in changes in the chemical composition e. Ideally, csf specimens should consist of these four 4 tubes each containing 23 ml of fluid. The purpose of this paper is to report cerebrospinal fluid csf findings in multiple sclerosis ms from our laboratory, to discuss the implications of csf abnormalities in terms of diagnosis. Nearly every section of the laboratory can be involved in the evaluation of cerebrospinal. Csf protein, glucose, gram stain, cultures, wbc, leukocytes. Proper eval uation of csf depends on knowing which tests to order, normal ranges for the patients age. Cerebrospinal fluid csf analysis is a way of looking for conditions that affect your brain and spine.
Clinical and laboratory standards institute, 950 west valley road, suite 2500, wayne, pennsylvania 19087 usa, 2006. A prospective study to determine the value of cerebrospinal fluid analysis in the differential diagnosis of meningitis was performed in 710 consecutively observed patients, both children and adults, who underwent lumbar puncture due to suspected central nervous system infection. Csf testing is performed to evaluate the level or concentration of different substances and cells in csf in order to diagnose conditions affecting the brain and spinal cord central nervous system. Cerebrospinal fluid csf analysis and interpretation in. Cerebrospinal fluid csf analysis is a set of laboratory tests that examine a sample of the fluid surrounding the brain and spinal cord. Laboratorygeneral specimen collection and handling.
Repeat lumbar puncture after 12 to 24 hours, if performed, generally shows an evolution to a lymphocytic predominance. Csf samples contaminated by blood must be immediately centrifuged because red blood cell hemolysis can lead to oxidation and. The clinical and laboratory standards institute consensus process, which is the mechanism for moving a document through. Diagnostic value of lactate dehydrogenase isoenzymes in cerebrospinal fluid. Csf must be examined immediately within one hour, after the specimen is collected. The probabilities of detecting microorganisms by staining and by culturing are related to the volume of specimen that is co ncentrated and examined tenney et al. Common laboratory lab values csf analysis globalrph. Standard operating procedures for surveillance of meningitis.
The diagnosis of postneurosurgical infections, especially hcam, is frequently difficult given the limitations of symptoms, signs, laboratory, csf tests, and imaging studies. Laboratory markers for diagnosis and prognosis this clinical focus provides an overview of how laboratory testing can assist with obtaining a diagnosis and prognosis for osteoarthritis and rheumatoid arthritis. The purpose of this study was to compare the accuracy of this urine test strip and of the istat chem8 and cg4 cartridges with a standard hospital bench top analyser in order to determine if these poc devices have a potential role in the biochemical analysis of cerebrospinal fluid csf protein, csf glucose and csf lactate, respectively. Laboratory tests that may be performed on csf include, but are not limited to, macroscopic evaluation, microscopic evaluation of cell count and type, chemical analysis, microbiology cultures, and immunologic and molecular analyses.
Cerebrospinal fluid csf analysis is a set of laboratory tests that examine a sample of. Approach to csf analysis in acute brain conditions. If you continue browsing the site, you agree to the use of cookies on this website. Cerebrospinal fluid csf is a clear fluid circulating in the intracranial and spinal compartments.
Currently, visual assessment of csf, microscopic examination for pathologic cells, and biochemical analysis for protein and glucose form the. Cerebrospinal fluid csf testing evaluates the clear, watery liquid that flows around the brain and spinal cord. Lumbar puncture and csf analysis in adults an update. Meningitis lab manual primary culture and presumptive. This will provide enough sample to perform multiple tests with adequate volume for repeat analysis and addon tests. Cerebrospinal fluid cytology and clinical analysis of 34.
Cerebrospinal fluid csf collection guidelines collection collect appropriate volumes of csf in sequential order into four sterile, screw capped tubes consecutively numbered 1 to 4. New criteria for the diagnosis of multiple sclerosis ms were published as the result of an internationally formed committee. Infectious diseases of the brain and spinal cord, including meningitis and. Ti is a biphasic medium that is useful for the primary culture of meningococci and other etiological agents of bacterial meningitis s. Any suspected case with macroscopic aspect of cerebrospinal fluid csf turbid.
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