Cerebrospinal fluid analysis

Dean Seehusen, Mark M. Reeves, Demitri A. Fomin

Research output: Contribution to journalReview article

128 Citations (Scopus)

Abstract

Lumbar puncture is frequently performed in primary care. Properly interpreted tests can make cerebrospinal fluid (CSF) a key tool in the diagnosis of a variety of diseases. Proper evaluation of CSF depends on knowing which tests to order, normal ranges for the patient's age, and the test's limitations. Protein level, opening pressure, and CSF-to-serum glucose ratio vary with age. Xanthochromia is most often caused by the presence of blood, but several other conditions should be considered. The presence of blood can be a reliable predictor of suibarachnoid hemorrhage but takes several hours to develop. The three-tube method, commonly used to rule out a central nervous system hemorrhage after a "traumatic tap," is not completely reliable. Red blood cells in CSF caused by a traumatic tap or a subarachnoid hemorrhage artificially increase the white blood cell count and protein level, thereby confounding the diagnosis. Diagnostic uncertainty can be decreased by using accepted corrective formulas. White blood cell differential may be misleading early in the course of meningitis, because more than 10 percent of cases with bacterial infection will have an initial lymphocytic predominance and viral meningitis may initially be dominated by neutrophils. Culture is the gold standard for determining the causative organism in meningitis. However, polymerase chain reaction is much faster and more sensitive in some circumstances. Latex agglutination, with high sensitivity but low specificity, may have a role in managing partially treated meningitis. To prove herpetic, cryptococcal, or tubercular infection, special staining techniques or collection methods may be required. Copyright

Original languageEnglish (US)
Pages (from-to)1103-1108
Number of pages6
JournalAmerican family physician
Volume68
Issue number6
StatePublished - Sep 15 2003

Fingerprint

Meningitis
Cerebrospinal Fluid
Viral Meningitis
Hemorrhage
Cerebrospinal Fluid Pressure
Spinal Puncture
Agglutination
Latex
Subarachnoid Hemorrhage
Leukocyte Count
Bacterial Infections
Uncertainty
Blood Proteins
Primary Health Care
Reference Values
Neutrophils
Leukocytes
Central Nervous System
Erythrocytes
Staining and Labeling

ASJC Scopus subject areas

  • Family Practice

Cite this

Seehusen, D., Reeves, M. M., & Fomin, D. A. (2003). Cerebrospinal fluid analysis. American family physician, 68(6), 1103-1108.

Cerebrospinal fluid analysis. / Seehusen, Dean; Reeves, Mark M.; Fomin, Demitri A.

In: American family physician, Vol. 68, No. 6, 15.09.2003, p. 1103-1108.

Research output: Contribution to journalReview article

Seehusen, D, Reeves, MM & Fomin, DA 2003, 'Cerebrospinal fluid analysis', American family physician, vol. 68, no. 6, pp. 1103-1108.
Seehusen D, Reeves MM, Fomin DA. Cerebrospinal fluid analysis. American family physician. 2003 Sep 15;68(6):1103-1108.
Seehusen, Dean ; Reeves, Mark M. ; Fomin, Demitri A. / Cerebrospinal fluid analysis. In: American family physician. 2003 ; Vol. 68, No. 6. pp. 1103-1108.
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