13. CSF Flashcards
Normal volume
Total volume of CSF is 150 ml
Daily production
550 ml/day
Formed by
Choroid plexus 50% & walls of ventricles 50%
Pressure
8-15 mmHg, measured at lumbar puncture
Appearance
Clear, colourless
CSF total protein, glucose, cell count
P: 15-60 mg/100 mL, G: 50-80 mg/100 mL, CC: 0-5 WBC & no RBC
Abnormal CSF; blood
Blood into CSF by
- accidental puncture of a leptomeningeal vein during entry of the LP needle
- drawn initially and gradually clears, if not –> indicates subarachnoid hemorrhage
Abnormal CSF; WBC
Pleocytosis: - Infectious - Noninfectious Polymorphonuclear pleocytosis: - Acute suppurative meningitis Mononuclear cells: - Viral infections (meningoencephalitis, aseptic meningitis) - Syphilis - Neuroborreliosis - Tuberculous meningitis - MS - Brain abscess and tumors
Abnormal CSF; tumor cells
Indicate dissemination of metastatic or primary brain tumors in the subarachnoid space
- Medulloblastoma
Abnormal CSF; proteins
Bacterial meningitis: Rise to 500 mg/dl
Meningitis, encephalitis, intracranial tumors, subarachnoid hemorrhage, cerebral infarction: 150-200 mg/dl
Guillain-Barré syndrome and acoustic and spinal schwannoma
MS: Normal or mildly increased
- Often elevated IgG in CSF, but not in serum
Abnormal CSF; low glucose
Indicate suppurative, tuberculous and fungal infections, sarcoidosis, and meningeal dissemination of tumors. Glucose is consumed by leukocytes and tumor cells.
CSF biomarkers
Alzheimer’s disease:
- Beta amyloid 42 (Aβ42) decreased
- Total-tau (t-tau) increased
- Phosphorylated tau (p-tau) increased
- S100B increased
Creutzfeldt-Jacob disease:
- T-tau increased
- 14-3-3-protein increased
- CSF transferrin (Tf) decreased (sporadic CJD)
Dementia, acute stroke, encephalitis: 14-3-3-protein increased
Trauma, stroke, hypoxic-ischemic encephalopathy (premature infants): S100B increased
Melanoma & brain tumors: Blood and CSF S100B increased
