The document discusses cerebrospinal fluid (CSF), including its formation, circulation, composition, and diagnostic testing. CSF is formed by the choroid plexus in the brain ventricles and circulates around the brain and spinal cord. Testing of CSF samples obtained via lumbar puncture can help diagnose various central nervous system conditions, particularly infections like meningitis. Abnormal CSF findings include decreased glucose, increased protein, and presence of cells, which can indicate different types of meningitis and other disorders.

2. - Is a clear, colorless body fluid ..
- bathes the ..

3. Formed and Secreted by the choroid
plexus, special tissue that has many blood
vessels and lines the small cavities (ventricles)
in the
brain ..

5. CIRCULATION OF CSF
Circulation: CSF is mainly formed in choroid pleaxus of
the lateral ventricle.
CSF passes from the lateral ventricle to the third ventricle
through the interventricular foramen (foramen of Monro).
From third ventricle it passes to the fourth ventricle
through the cerebral aqueduct. The circulation is aided by
the arterial pulsations of the choroid plexuses.
From the fourth ventricle (CSF) passes to the
subarachnoid space around the brain and spinal cord
through the foramen of magendie
and foramina of luschka.

9. If this protective barrier disrupts may
result in a change in the normal level or
type of constituents of CSF.
Because CSF surrounds the brain and
spinal cord, testing a sample of CSF can
be very valuable in diagnosing a variety
of conditions affecting the central
nervous system (CNS) ..

10. CSF COMPOSITION
Normal CSF; clear, colorless, and odorless

11. 1) Infectious diseases:
such as meningitis and encephalitis and
meningitis.Testing is used to determine if
infection is caused by Bacteria, viruses or,
less commonly, byTuberculosis,
Fungi or Parasites.

14. CSF usually collected in three sterile tubes
•
Label 1 / Tube 1 – used for chemical and serologic
test
( tubes are frozen)
•
Label 2 / Tube 2 – used for microbiology lab
( room temp.)
•
Label 3 / Tube 3 – used for hematology (cell count) (
refrigerated)

18. 1)CSF glucose– Normal is about 2/3 the
concentration of blood glucose. Glucose levels may decrease
when cells that are not normally present use up (metabolize)
the glucose.These may include bacteria or cells present due
to inflammation (WBCs) or
shed by tumors.
2)CSF protein– only a small amount is normally present in
CSF because proteins are large molecules and do not cross the
blood/brain barrier easily. Decreases in CSF protein are not
generally considered significant. Increases in protein are most
commonly seen with:
Meningitis and brain abscess
Brain or spinal cord tumors
Multiple sclerosis
Guillain-Barre- Syndrome
Syphilis

19. If any of the initial tests are abnormal or if the doctor has
reason to suspect a specific condition, then additional
testing may be ordered.This may include one or more of
the following:
3)CSF lactic acid — Often used to distinguish
betweenViral and Bacterial Meningitis.The level will usually
be increased with bacterial and Fungal meningitis while it
will remain normal or only slightly elevated with viral
meningitis.
4)CSF lactate dehydrogenase (LD) — Used to
differentiate between bacterial and viral meningitis;
the level is usually increased with bacterial
meningitis and not with viral meningitis; may also be
elevated with Leukemia.

20. 5)CSF C-reactive protein (CRP) is
an acute phase protein and is elevated
with inflammation. It is markedly increased
with bacterial meningitis. Since it is very
sensitive even with early bacterial
meningitis, it is often used to distinguish
between bacterial and viral meningitis.
6)CSF Chloride

21. 8)CSF PRESSURE
7) CSF Adenosine Deaminase: ADA testing
is most valuable in ruling out tuberculosis.

22. reddish color)

29. LUMBAR PUNCTURE
A lumbar puncture also called a spinal tap is a
procedure where a sample of cerebrospinal fluid is
taken for examination.
CSF is mainly used to diagnose meningitis [an
infection of the meninges].
It is also used to diagnose some other conditions of
the brain and spinal cord.

30. PRECAUTIONS FOR LUMBAR PUNCTURE
Asked to sign a consent form
Ask about taking any medicines
Are allergic to any medicines
Have / had any bleeding problems

Ask about medications such as aspirin or warfarin
Ask the female patient might be pregnant
Empty the bladder before the procedure

32. Level of entry

33. Spinal needle

34. Collecting the CSF

35. 
1. The main anatomical structure which
produces CSF is called the

A. Cerebral Cortex

B. Cerebellum

C Choroid Plexus

D. Foramen of Monroe

36. 
2.Which of the following is an
abnormal cerebrospinal fluid (CSF)
finding?

A. Glucose level that is less than 50% of
the plasma glucose level

B. Protein level of less than 0.5 g/l

C. Cell concentration of 0–5 cells/µl

37. 
3. Which of the following is true
about CSF analysis in bacterial
meningitis?

A. Raised CSF lactate suggests tuberculous
disease

B. CSF protein increased and Glucose
reduced

C. Antibiotic therapy should be delayed
until after a lumbar puncture to ensure that
bacterial cultures are positive

38. Thank You