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Cerebrospinal Fluid Interpretation
Cerebrospinal Fluid Interpretation
Cerebrospinal Fluid Interpretation
Cerebrospinal Fluid Interpretation
Cerebrospinal Fluid Interpretation
Cerebrospinal Fluid Interpretation
Cerebrospinal Fluid Interpretation
Cerebrospinal Fluid Interpretation
Cerebrospinal Fluid Interpretation
Cerebrospinal Fluid Interpretation
Cerebrospinal Fluid Interpretation
Cerebrospinal Fluid Interpretation
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Cerebrospinal Fluid Interpretation

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  • 1. 05/08/13 1E. S. MOKGWANE; 4TH YR MED
  • 2. CHARECTERISTICS OF NORMAL CSFTotal Volume: 150mlColour: colourless, like waterTransparency: clear, like waterOsmolality at 37o C: 281mOsm/LSpecific Gravity: 1.006 to 1.008Presure: 80-100 mm H2O05/08/13 2E. S. MOKGWANE; 4TH YR MED
  • 3. ACID-BASE BALANCEpH 7.31pCO2 47g mmHgHCO3 22g mEq/LSodium 138 – 150 mEq/LPotassium 2.7 to 3g mEq/LChloride 116 to 127 mEq/LCalcium 2.0 to 2.5 mEq/LMagnesium 2.0 to 2.5 mEq/LLactic Acid 1.1 to 2.8 mmol/L05/08/13 3E. S. MOKGWANE; 4TH YR MED
  • 4. APPEARANCE1. BRIGHT RED•Recent haemorrhage involving the subarachnoid•Damage to a blood vessel during puncture05/08/13 4E. S. MOKGWANE; 4TH YR MED
  • 5. APPERANCE2. XANTHOCROMIA•Suggests subarachnoid haemorrhage in recent past(days).Rarely Xanthochromia may be due to:• Severe Jaundice• Carotenaemia• Rifampicin05/08/13 5E. S. MOKGWANE; 4TH YR MED
  • 6. APPERANCE3. TURBIDwhite cells presentsuggest bacterial infection.05/08/13 6E. S. MOKGWANE; 4TH YR MED
  • 7. APPERANCE4. PIGMENTS• Oxyhaemoglobin – Released with lysis of red cellsdetected in the supernatant fluid within 2h after SAH.• Bilirubin – maximum at 48hrs after SAH.05/08/13 7E. S. MOKGWANE; 4TH YR MED
  • 8. TOTAL PROTEIN0.5% or 1/200 that of plasmaTypical reference values for a lumbar tap:Age g/L<1 month <1.91-3 months <0.953-12 months <0.51-10 years <0.4>10 years <0.705/08/13 8E. S. MOKGWANE; 4TH YR MED
  • 9. TOTAL PROTEIN IS RAISED IN:1. Infection (white cells, pus) e.g. bacterial meningitis2. Blood Contamination3. Chronic inflammatory diseases of the CNS.4. Froin’s syndrome5.Lysis of contaminated blood from traumatic tap6.Increased permeability of the epithelial membrane7.Increased production by CNS tissue05/08/13 9E. S. MOKGWANE; 4TH YR MED
  • 10. DECREASED CSF GLUCOSE• Disorder in carrier –mediated transport of glucose intoCSF• Active metabolism of glucose by cells or organisms• Increased metabolism by CNS eg Brain tumor, diffuse,meningeal neoplasia.05/08/13 10E. S. MOKGWANE; 4TH YR MED
  • 11. SUMMARY OF A TYPICAL CSFFINDINGSNORMAL BACTERIA VIRAL TBCells 0-5 >1000 <1000 <500Polymorphs 0 Predominate Early +/- IncreasedLymphocytes 5 Late Predominate IncreasedGlucose 60-80 Decreased Normal DecreasedCSF Plasma:Glucose ratio66% <40% Normal <30%Protein 5-40 Increased +/- Increased IncreasedCulture Negative Positive Negative +TB05/08/13 11E. S. MOKGWANE; 4TH YR MED
  • 12. END05/08/13 12E. S. MOKGWANE; 4TH YR MED

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