Topics Discussed: cerebrospinal fluid; cerebrospinal fluid analysis; diagnostic spinal puncture; neurology.
Excerpt:"Indications
- Obtaining cerebrospinal fluid (CSF) for the diagnosis of central nervous system (CNS) disorders such as meningitis/encephalitis. Infections that can be diagnosed are bacterial, viral, fungal and TORCH (Toxoplasmosis, Other infections[usually syphilis], Rubella, Cytomegalovirus, and Herpes simplex).
- To aid in the diagnosis of intracranial hemorrhages. CSF studies are indicative but not diagnostic for intracranial hemorrhage. Can see large number of RBC's, xanthochromia, increased protein content, and hypoglycorrhachia (abnormally low CSF glucose content).
- To diagnose an inborn error of metabolism. CSF amino acid analysis can be obtained to rule out nonketotic hyperglycinemia. Postmortem CSF (1–2 mL frozen specimen) is recommended when an inborn error of metabolism is suspected.
- Draining CSF in communicating hydrocephalus associated with intraventricular hemorrhage. (Serial lumbar punctures for this are controversial.)
- Administration of intrathecal medications or contrast material.
- Monitoring efficacy of antibiotics used to treat CNS infections by examining CSF fluid.
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