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Cerebrospinal Fluid

Analyse the following:

Ñ  Opening pressure

Ñ  Naked eye appearance

Ñ  Protein

Ñ  Glucose

Ñ  Cells

 

Title:                            

Ñ  Opening pressure

Definition:

Ñ  Initial CSF pressure measured with the patient in the lateral position

Ñ  Reflection of intracranial pressure

Ñ  Normal: 50-180 mm of H₂O

Pathogenesis

Pathological Process

Ñ  Increased production of CSF

Ñ  Mass lesion

Ñ  Haemorrhage

Ñ  Decreased outflow of CSF due to obstruction to CSF pathways

Causes

Internal Factors

Ñ  Benign intracranial hypertension

Ñ  Meningitis

Ñ  Subarachnoid haemorrhage

External factors

Ñ  Dural venous sinus thrombosis

 

Naked eye appearance

Ñ  Turbid

Ñ  Bloody

Ñ  Xanthochromia

Title:                            

Ñ  Turbid CSF

Definition:

Ñ  CSF not clear due to the presence of particulate matter

Pathogenesis

Pathological Process

CSF turbidity may be causes by the presence of the following in the CSF:

Ñ   Leucocytes

Ñ  Erythrocytes

Ñ  Fungi

Ñ  Bacteria

Ñ  Amoebae

Ñ   contrast media

Ñ  aspiration of epidural fat during puncture

Causes

Ñ  Meningitis

Ñ  Subarachnoid haemorrhage

 

 

Title:                            

Ñ  Bloody CSF

Definition:

Ñ  Presence of blood in the cerebrospinal fluid

Pathogenesis

Pathological Process

Ñ  Either due to trauma during the lumbar puncture or subarachnoid haemorrhage

Ñ  Traumatic tap , serial samples quantity of red cells diminishes

Causes

Ñ  Subarachnoid haemorrhage

Ñ  Traumatic tap

 

 

Title:                            

Ñ  Xanthochromia

Definition:

Ñ  Yellow discolouration of CSF

Pathogenesis

Pathological Process

Ñ  Due to either :

Ñ  Breakdown products of haemoglobin

Ñ  Excess protein

Causes

Ñ  Subarachnoid haemorrhage

Ñ  Froin’s syndrome

 

 

Title:                            

Ñ  Protein

Definition:

Ñ  Normal: 0.15-0.45 g/L

Pathogenesis

Pathological Process

Ñ  Increased protein is due to exudation  of protein or haemorrhage

Causes

Inflammation

Ñ  Meningitis

Ñ  Encephalitis

Ñ  Multiple sclerosis

Ñ  Neurosyphilis

Ñ  Guillain Barre syndrome

Ñ  SLE

Ñ  Sarcoidosis

Tumours

Ñ  Cerebral tumour

Ñ  Neurofibromatosis

Ñ  Lymphoma

Ñ  Myeloma

Ñ  Benign paraproteinaemia

Degeneration

Ñ  Carcinomatous neuropathy

Ñ  Diabetic neuropathy

 

 

Title:                            

Ñ  Glucose

Definition:

Ñ  Normal : 3.3-4.4 mmol/L (60-70% plasma glucose )

Pathogenesis

Pathological Process

Ñ  Utilisation of CSF glucose by cells

Causes

Inflammation

Ñ  Meningitis bacterial and fungal

Ñ  Toxoplasmosis

Ñ  Sarcoidosis

Neoplasm

Ñ  Leukaemia

Vascular

Ñ  Subarachnoid haemorrhage

 

 

Title:                            

Ñ  Cells

Definition:

Ñ  Normal :≤ 5/mL

Pathogenesis

Pathological Process

Ñ  Due to inflammation or infiltration of the meninges

Causes

Neutrophils

Ñ  Bacterial meningitis

Lymphocytes

Ñ  Viral meningitis

Ñ  Tuberculous  meningitis

Ñ  Fungal meningitis

Eosinophils

Ñ  Parasitic infections

Red cells

Ñ  Subarachnoid haemorrhage

 

 

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