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    CSF analysis

    Cerebrospinal fluid analysis

    Cerebrospinal fluid (CSF) analysis is a group of laboratory tests that measure chemicals in the fluid that surrounds and protects the brain and spinal cord. The tests may look for proteins, sugar (glucose), and other substances.

    How the Test is Performed

    A sample of CSF is needed. A lumbar puncture, also called a spinal tap, is the most common way to collect this sample. Less common ways to take a fluid sample include:

    • Cisternal puncture
    • Removal of CSF from a tube that is already in the CSF, such as a shunt, ventricular drain, or pain pump
    • Ventricular puncture

    After the sample is taken, it is sent to the laboratory for evaluation.

    How to Prepare for the Test

    Your health care provider will tell you how to prepare for lumbar puncture.

    Why the Test is Performed

    Analysis of CSF can help detect certain conditions and diseases. All of the following can be, but are not always, measured in a sample of CSF:

    • Antibodies and DNA of common viruses
    • Bacteria (including that which causes syphilis; see:VDRL test)
    • Cell count
    • Chloride
    • Cryptococcal antigen
    • Glucose
    • Glutamine
    • Lactate dehydrogenase
    • Oligoclonal banding to look for specific proteins
    • Total protein
    • Whether there are cancerous cells present

    Normal Results

    • Antibodies and DNA of common viruses: None
    • Bacteria: No bacteria grows in a lab culture
    • Cancerous cells: No cancerous cells present
    • Cell count: less than 5 white blood cells (all mononuclear) and 0 red blood cells
    • Chloride: 110 to 125 mEq/L
    • Fungus: None
    • Glucose: 50 to 80 mg/dL(or greater than two-thirds of blood sugar level)
    • Glutamine: 6 to 15 mg/dL
    • Lactate dehydrogenase: less than 2.0 to 7.2 U/mL
    • Oligoclonal bands: 0 or 1 bands that are not present in a matched serum sample
    • Protein: 15 to 60 mg/dL

    Normal value ranges may vary slightly among different laboratories. Talk to your doctor about the meaning of your specific test results.

    The examples above show the common measurements for results for these tests. Some laboratories use different measurements or may test different specimens.

    Note: mg/dL = milligrams per deciliter

    What Abnormal Results Mean

    An abnormal CSF analysis result may be due to many different causes, including:

    • Cancer
    • Encephalitis (such as West Nile and Eastern Equine)
    • Hepatic encephalopathy
    • Infection
    • Inflammation
    • Reye syndrome
    • Meningitis due to bacteria, fungus, tuberculosis, or a virus
    • Multiple sclerosis (MS)
    • Alzheimer's disease
    • ALS

    References

    Griggs RC, Jozefowicz RF, Aminoff MJ. Approach to the patient with neurologic disease. In: Goldman L, Schafer AI, eds. Cecil Medicine. 24th ed. Philadelphia, Pa: Saunders Elsevier; 2011:chap 403.

    Rosenberg GA. Brain edema and disorders of cerebrospinal fluid circulation. In: Daroff RB, Fenichel GM, Jankovic J, Mazziotta JC, eds. Bradley’s Neurology in Clinical Practice. 6th ed. Philadelphia, Pa: Saunders Elsevier; 2012:chap 59.

    Martorana A, Sancesario GM, Esposito Z, et al. Plasmin system of Alzheimer’s disease: CSF Analysis. J Neural Transm. 2012:119:763-769.

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    • CSF chemistry

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      • CSF chemistry

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      A Closer Look

        Self Care

          Tests for CSF analysis

          Review Date: 5/28/2013

          Reviewed By: Luc Jasmin, MD, PhD, FRCS (C), FACS, Department of Neurosurgery at Cedars-Sinai Medical Center, Los Angeles CA; Department of Surgery at Los Robles Hospital, Thousand Oaks CA; Department of Surgery at Ashland Community Hospital, Ashland OR; Department of Surgery at Cheyenne Regional Medical Center, Cheyenne WY; Department of Anatomy at UCSF, San Francisco CA. Review provided by VeriMed Healthcare Network.

          The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed medical professional should be consulted for diagnosis and treatment of any and all medical conditions. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. © 1997- A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.
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