Lumbar Puncture

Question 1

CSF Normal values <1mo &amp; <1wo (w units)
NQ,
 L
Pro
Glu CSF:Bld

Answer 1

NQ 0 x10 6/L
L <11 (<18)
Pro <1.0 g/L (<1.3)
Glu >0.6 (or >2.1mmol/L) 
CAVEAT - EMPERIC TX

Question 2

CSF Normal values >1mo w units
NQ,
 L
Pro,
Glu CSF:Bld

Answer 2

NQ 0 x10 6/L
L <5
Pro <0.4 g/L
Glu >0.6 (or >2.5mmol/L)

Question 3

CSF findings for bacterial meningitis? w units?
NQ
L
Pro
Glu

Answer 3

NQ 100- 10,000 x10 6/L 
L <100
P >1.0 g/L
Glu CSF:Bld <0.4
gramstain 60% Neg
...OR NORMAL

Question 4

CSF findings for VIRAL meningitis? w units?
NQ
L
Pro
Glu

Answer 4

Nq <100 x10 6/L
L 10-1000
Pro 0.4-1 g/L
Glu usu N
.... OR NORMAL

Question 5

Effect of ______ of CSF?

• seizures
• prior ABs
• bact v viral
• traumatic tap

Answer 5

• assume Seizures don’t incr cell ct
• AB’s if <24hrs unlike to affect cell ct/ biochem
• NQ may predominate first 24hrs viral, and early bact may mimic viral
• *IF SUSPECT, TX**

Question 6

Effect of ______ of CSF by traumatic tap?

Answer 6

Some guidelines suggest allow:

• 1 white blood cell for every 500 to 700 rbc
• 0.01g/L protein for every 1000rbc
• safest to count total wbc and disregard the red cell count –> If more white cells than the NR for age–> treat**