CONTENT
Preface Specimen Collection Opening Pressure Total cell count Differential cell count Glucose Protein
Medicine School of Shandong University 2
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Preface
Cerebrospinal fluid (CSF) is mostly derived through the choroid plexuses. 500mL/day approximately CSF protects the brain and spinal cord, and collects waste, circulates nutrients, cushions and lubricates the central nervous system (CNS).
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Specimen Collection
Lumbar puncture (LP) is the insertion of
a needle into the subarachnoid space (the area under the membrane that surrounds the brain and spinal cord) of the lumbar (lower back) region for diagnostic or therapeutic purposes. This allows access to the cerebrospinal fluid (CSF) in which the brain and spinal cord float. Although the subarachnoid space can be accessed from other levels, the lumbar region is most often used as it allows the needle to be inserted below the end of the spinal cord.
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Opening Pressure
Normal opening pressure in adults is 90~180mmH2O, 10~100mmH2O in children.
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Elevated pressure
Congestive heart failure Meningitis Superior vena cava syndrome Cerebral edema Mass lesion
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Decreased pressure
Spinal-subarachnoid block Dehydration Circulatory collapse CSF leakage
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Glucose
The normal Glucose is about 60% compared to serum level. Normal 50~80mg/dl Elevated Glucose: Diabetes mellitus, DM Decreased Glucose: Bacterial Meningitis
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Total Protein
Over 80% of CSF protein content is derived from the plasma. An increased CSF protein serves as a useful but nonspecific indicator of disease. Normal level 15~45mg/dl.
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