Cerebrospinal fluid

CEREBROSPINAL
FLUID
Prepared by:
Shaimaa sayed , Salma Yahya , Ghada Farah

CONTENTS …
Introduction
Physical properties
Functions
Formation
Circulation
CSF analysis
Hydrocephalus

CSF IS…
 Clear colorless and transparent fluid.
 Circulates through cavity of the :-
-brain
-subarachnoid space
-central canal of spinal cord
 Part of extracellular fluid (ECF)

CSF IS…
 Covered by : -
1. Pia meter (Inner membrane)
2. Arachnoid meter (center membrane)
3. Dura meter (Outer membrane)

CSF IS …
 Rate of formation :-
About 0.3 ml/min
And Normally 500ml of CSF is formed everyday
and equal amount is absorbed .

LOCATION OF CSF..
Two lateral ventricles
Third ventricle
Fourth ventricle
Spinal cord central canal
Subarachnoid space
Continuous with extracellular fluid
of brain parenchyma.

PHYSICAL PROPERTIES ….
1-Total volumes
 Adults :140 – 170 ml
Children : 10 – 60 ml

PHYSICAL PROPERTIES …
2-Spacific gravity : 1.005
3- ph : 7.28 - 7.32
4- appearance : clear
5-composition

PHYSICAL PROPERTIES…
For appearance : -
- clear & colorless is Normal
- bright red indicate presence of
blood
- turbid indicate presence of white
cells

FUNCTIONS OF CSF ..
Protects & lubricates the brain
Provides nutrients ,remove waste
Modulates pressure changes
 serves as a chemical buffer to maintain
constant ionic environment
Serves as a transport medium for
nutrients and metabolites ,endocrine
substansis and even neurotransmitters

FORMATION OF CSF ..
 The CSF is formed mainly in the brain
ventricles, and that the majority of the
remaining CSF is probably produced by
the ependymal surface of ventricles.
 It is generally accepted that CSF flows
unidirectional from the brain ventricles
to the subarachnoid space with the
exchange of various substances
between the CSF and interstitial
compartments.

FORMATION OF CSF ..
Choroid plexuses are the main site of
CSF production.
Then.. The passage of the plasma ultra
filtrate through the endothelium ,
facilitated by hydrostatic pressure.
Then.. Passes into the ventricles
An active metabolic process which
transforms the ultra filtrate into
secretion CSF.

CSF CIRCULATION ..
The amount of CSF formation in the
day equal
to the amount of absorption.
Vf = Va

WHY?
CSF analysis can accurately distinguish
between a wide range of CNS diseases.
 Conditions found by CSF analysis can be
placed into four main categories:
1- infectious diseases.
2- hemorrhaging.
3- immune response disorders.
4- tumors.

CSF analysis may be ordered when a
patient has one or more of the following
symptoms :
 severe, unremitting headache
 stiff neck
 light sensitivity
 dizziness
 speaking difficulties
 trouble walking or poor coordination
 fatigue, lethargy, muscle weakness

How to colect the
sample to make
analysis ??
It’s easy by
Lumber Puncture

LUMBER PUNCTURE
A lumbar puncture (or LP, and
colloquially known as a spinal tap) is
a diagnostic procedure that is
performed in order to collect a
sample of cerebrospinal fluid (CSF)
for biochemical , microbiological,
and cytological analysis .

APPEARANCE OF CSF
In normal cases, CSF is clear and
colorless.
In cases of malady, the appearance
change according to the case.
We will discuss some of these in the
following:

1- Xanthochromic :
(Bright red or yellow)
This indicates the presence of blood.
The appearance of fresh blood in all
tubes supports the diagnosis of a
subarachnoid hemorrhage.
2- Turbid :
This indicates the presence of white cells
and is suggestive of a CNS infection.

CELL COUNTS
1- Increased Neutrophils in CSF
This indicates a bacterial meningitis,
cerebral abscess.

2- Increased Lymphocytes in CSF:
 This indicates a viral meningitis,
tuberculosis, syphilis, fungal and
parasitic infections.
 Degenerative diseases of the CNS,
such as multiple sclerosis, will also
generate elevated lymphocyte counts.

CSF DISORDERS
1- CSF Glucose:
 CSF glucose is derived from blood glucose
hence, ideally CSF glucose level should be
compared with fasting plasma glucose level
for adequate clinical interpretatio
 Decrease duo to hypoglycemia , tuberculosis.
Increase duo to high blood sugar.

2- CSF Pressure:
Increase duo to increases intra cranial
pressure
Decrease due to shock ,fainting or
diabetic coma.
3- CSF Protein :
Increase duo to blood in CSF ,tumor.
Decrease duo to rapid CSF production.

Hydrocephalus
(water on brain)

HYDROCEPHALUS
 The term hydrocephalus is derived from the
Greek words "hydro" meaning water and
"cephalus" meaning head.
 It is an abnormal collection of cerebrospinal
fluid (CSF) resulting in abnormal widening of
spaces in the brain.
 Causes of “Hydrocephalus” may be:
-Excessive production
-Decreased absorbtion
-Obstruction

TYPES OF HYDROCEPHALUS
Communicating and Non-
communicating
Acute and chronic
Congenital and acquired

(A)1- Non-communicating (obstructive):
 CSF circulation is blocked at or proximal to fourth
ventricular outlet foramina.(enlargement of
ventricles proximal to the block)
2- Communicating (non-obstructive):
 due to excessive formation of CSF or lack of
absorption
 the obstruction of CSF flow is in the
subarachnoid space from prior bleeding or
meningitis.
 This causes thickening of the arachnoid leading
to blockage of the return-flow channels.

(B) 1- Acute :
 hydrocephalus caused by tumor
 Develops within days or few weeks
 Manifests with rapid progression of symptoms
 Requires early attention and treatment .
2- Chronic :
 Over months (or even years)
 Subtle signs of memory impairment,
walking difficulty, urinary incontinence.
 Chronic hydrocephalus can present acutely
because of changes in the pathophysiology of
the CSF absorption or flow.

(C) 1- Congenital :
 Present at birth or few weeks/months after
birth.
2- Acquired
 Infection (post-meningitis)
 Post – hemorrhagic (SAH,IVH)
 Tumors

Treatment
Diversion of CSF:
1- Ventriculoperitoneal shunt
2- Lumboperitoneal shunt

Cerebrospinal fluid

More Related Content

What's hot

Similar to Cerebrospinal fluid

Recently uploaded

Cerebrospinal fluid