Cerebrospinal fluid (CSF) is formed by selective dialysis of plasma by the choroid plexus in the ventricles of the brain. It circulates in the subarachnoid space around the brain and spinal cord, acting as a cushion and transporting substances. CSF is composed primarily of water, and contains proteins, glucose, and other components. It is collected through lumbar puncture between vertebrae in the lower back or through cisternal puncture in the neck, and analyzed physically, chemically, and microscopically to examine properties, cell counts, and detect any abnormalities.

1. Cerebrospinal fluid (CSF)
Prepared by :-Bipul Kumar Mahto

2. Introduction of CSF
 CSF is formed by selective dialysis of plasma by the choroid
plexue of the ventricles of the brain .
 Foramine in the fourth ventricle it passes into subarachnoidal
cisterns at the base of the brain .
 Absorbed into the blood in the cerebral veins and dural
sinuses .
 It is present in the cavity that surrounds the brain in the skull
and the spinal cord in the spinal column .
 It is a part of extracellular fluid .

3. Human Brain : Cerebrospinal fluid (CSF) synthesis

4. Function of CSF
 It helps to protect the brain and spinal coard from injury by acting like a fluid
buffer .
 Also acts as a medium for the transfer of substances from the brain tissue and
spinal coard to blood .
 It maintain intracranial pressure.
 Protection
 Nutrition
 Removal of waste
 lubrication

5. Formation of CSF
 CSF is formed by the Choroid plexuses , Situated within the ventricles.
 Choroid plexuses are tuft of capillaries present inside the ventricles.
 A large amount of CSF is formed in the lateral ventricles.
 Dura meter
 Arachnoid
 Pia

6. Properties of csf
 Color :-. Colorless
 pH. :-. 7.3 – 7.4
 Appearance. :-. Clear
 Volume. :-. 90 – 150 ml (Adult)
 Clot formation. :-. No clot formation on standing
 Specific gravity :-. 1.003 – 1.008
 Reaction : - slightly

7. Location of csf
 Two lateral ventricles
 Third ventricles
 Fourth ventricles
 Spinal cord central canal
 Subarachnoid space
 Contineous with extracellular fluid of brain parenchyma

8. Specimen collection for CSF
 Specimen should be collected by a physician,a specially trained technician or
nurse.
 Sterile lumbar puncture needle is inserted between the 3rd and 4th lumbar
vertebrae to a depth of 4-5 cm
 Stylet the fluid is collected through the needle into 2 test tube .
 Tube 1st : (sterile tube ) : About 0.5ml or few drops of csf.
 Tube 2nd : About 3-5ml of csf

9. Composition of csf
1. 99.1% H2O
2. 0.1 % solids
1. Organic
 Sugar
 Creatinine , Cholesterol, Faty Acid
 Amino acid
 Lactic Acid
 Protein
 Urea , Uric acid
2. Inorganic
 Sodium
 Potassium
 Bicarbonates
 megnasium

10. Interpretation of Cerebrospinal fluid
Analysis

11. Collection of CSF
 CSF is collected by 2 method .
1. Lumber Puncture
2. Cisternal Puncture
1. Lumber Puncture
 In this the needle is introduced into the subarachnoid space in the lumber region.

12. 2. Cisternall Puncture
 In this a needle between the occipital bone and atlas so that it enters the cisterna

13. Important Precautions
 The collected CSF specimen must be examined immediately (within 1
hours).
 Specimen collected for bacterial culture should not be stored in the
refrigerator (Neisseria meningitis is killed by exposure to cold).
 Cells are trypanosomes are rapidly lysed after the collection of csf .

14. Routine examination of csf
 There are 3 examination of csf
1. Physical Examination
2. Chemical Examination
3. Microscopic examination

15. Physical examination
 Observe the specimen
1. Color
2. Appearance
3. Presence of blood
4. Thick viscosity – presence of protein in csf
5. PH – 7.38 – 7.42
 Fibrin clot formation takes place due to the presence of fibrinogen (blood brain
barrier disturbance )

16. Chemical Examination
1. Glucose
2. Protein
3. Globulin
4. Fats
5. Lactose
6. Chlorides in csf

17. Microscopic examination
 Direct wet mount
1. Candida
2. Anaerobic encepharits
 Indian ink
 Gram stain
 Zein neilsen stain
 Acid fast staining
 Leishman stain
 Differentail leukocyte count

18. Collection of Cerebrospinal fluid (CSF)

19. bipulkrmahto5@gmail.com