Cerebral Spinal Fluid (CSF)

Cerebrospinal fluid (CSF) collection is a test to look at the fluid that surrounds the brain and spinal cord.
CSF acts as a cushion, protecting the brain and spine from injury. The fluid is normally clear. Ithas the same consistency as water. The test is also used to measure pressure in the spinal fluid.

Apparatus Procedure Normal Results Precautions

Apparatus: Description goes here...

Procedure: Description goes here...

• Gross appearance: Normal CSF is clear and colorless.
• CSF opening pressure: 50–175 mm H₂O.
• Specific gravity: 1.006–1.009.
• Glucose: 40–80 mg/dL.
• Total protein: 15–45 mg/dL.
• LD: 1/10 of serum level.
• Lactate: less than 35 mg/dL.
• Leukocytes (white blood cells): 0–5/microL (adults and children); up to 30/microL (newborns).
• Differential: 60–80% lymphocytes; up to 30% monocytes and macrophages; other cells 2% or less. Monocytes and macrophages are somewhat higher in neonates.
• Gram stain: negative.
• Culture: sterile.
• Syphilis serology: negative.
• Red blood cell count: Normally, there are no red blood cells in the CSF unless the needle passes through a blood vessel on route to the CSF.

In some circumstances, a lumbar puncture to withdraw a small amount of CSF for analysis may lead to serious complications. Lumbar punctures should be performed only with extreme caution, and only if the benefits are thought to outweigh the risks. In people who have bleeding disorders, lumbar puncture can cause hemorrhage that can compress the spinal cord. If there is increased spinal column pressure, as may occur with a brain tumor and other conditions, removal of CSF can cause the brain to herniate, compressing the brain stem and other vital structures and leading to irreversible brain damage or death. Bacteria introduced during the puncture may cause meningitis. For this reason, aseptic technique must be followed strictly, and a lumbar puncture should never be performed at the site of a localized skin lesion.

Specimens should be handled with caution to avoid contamination with skin flora. They should be refrigerated if analysis cannot be performed immediately.