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19 Cards in this Set

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Total volume of CSF?

150 mL

Normal resting pressure of CSF?

Between 150 and 180 mm H2O; varies from 65 mm H2O to 200 mm H2O

Major cause of error in measurement?

Failure to position the patient in lateral decubitus, where the right atrium pressure can serve as the reference 0

Which four main CSF variables are examined?

1. Glucose (relative to serum glucose)


2. Quantity and type of red and white blood cells


3. CSF protein level


4. Opening pressure

Typical CSF findings in bacterial infections?

>100 mg/dL protein, <40% glucose, >500 WBC, predominantly PMNs

Typical CSF findings in viral infections?

<120 mg/dL protein, >40% glucose, 10-500 cells, lymphocytes

Typical CSF findings in granulomatous disease?

>50 mg/dL protein, <40% gluocse, 10-1000 cells, lymphocytes

What difference in glucose between serum and CSF in diabetic patients should be considered abnormal?

A CSF to serum ratio of glucose less than 30%; ideally, the serum glucose value should be measured 1 hour before LP to account for CSF glucose equilibration

A low glucose value in the CSF (hypoglycorrhachia) may be indicative of what?

CNS infection, inflammation, or other meningeal reactive processes

A low glucose value in bacterial meningitis is thought to be a result from what?

Shutdown of the glucose transporter system. Leukocyte utilization contributes to a lesser extent, but bacterial consumption does not contribute.

What is the low CSF protein count a result of?

Blood brain barrier, and the gradient is thus large. CSF protein increase reflects the degree of impairment of the blood-brain barrier

What is Froin syndrome?

CSF with a very high protein value and xanthochromia, resulting in spinal fluid that spontaneously coagulates

Usually, Froin syndrome is due to what?

Loculation of the CSF in portions of the subarachnoid space, where spinal fluid circulation is compromised by an inflammatory or neoplastic obstruction

Clotting of CSF is due to?

Leakage of fibrinogen and other clotting factors from the serum

Causes of a very increased CSF protein value (>500 mg/dL)? (5)

1. TB meningitis


2. Spinal block


3. Subarachnoid hemorrhage


4. Inflammatory polyneuropathy


5. Meningeal involvement by a malignancy

Causes of xanthochromia?

1. Oxyhemoglobin - 4-6 hours after bleeding


2. Bilirubin - 2 days after bleeding

How is the CSF igG index calculated?

(CSF IgG / Serum IgG) / (CSF albumin / serum albumin) = CSF IgG index

Hallmark CSF finding in inflammatory polyradiculopathies?

"Cytoalbuminologic dissociation", which reflects an increased CSF protein value in the setting of a normal CSF WBC count. However, up to 10% of patients may have normal CSF protein value

CSF obtained directly from ventricles have a higher or lower glucose value than CSF from the lumbar sac?

Always higher glucose value in the ventricles