Analysis of cerebrospinal fluid

Liquor (spinal fluid) is formed in the ventricles of the brain by sweating blood plasma through the walls of the vessels, and is also secreted by the cells of the vascular plexuses. From the ventricles, it enters the brain cisterns and the subarachnoid space. For a day, from 400 to 600 ml of livcour is formed.

Investigation (analysis) of cerebrospinal fluid has an important diagnostic value for diseases of the central nervous system and meninges, such as encephalitis (inflammation of the brain), meningitis (inflammation of the meninges), arachnoiditis (inflammation of the arachnoid membrane), syphilis of the brain, cerebral circulatory disorders, tumors, trauma.

General clinical study of liquor includes the study of its physico-chemical properties and cellular composition.

Reference parameters (norm) of the cerebrospinal fluid

Characteristics	Indicators
Colour	Colorless
Transparency	Full
Density:
With lumbar puncture	1.006-1.007
With ventricular puncture	1.002-1.004
Reaction	Low alkaline
Protein:
With lumbar puncture	0.2-0.3 g / l
With ventricular puncture	0.1-0.22 g / l
Globulin reactions:
Pandi's reaction	Negative
Reaction of Non-Apelt	Negative
Glucose:
With lumbar puncture	2.8-3.9 mmol / l
With ventricular puncture	2.8-3.9 mmol / l
Chlorides:
With lumbar puncture	120-130 mmol / l
With ventricular puncture	120-130 mmol / l
Cytosis:
With lumbar puncture	7-10 cells / 3 μl (2-3 × 10 6 / L)
With ventricular puncture	0-3 cells / 3 μl (0-1 × 10 6 / L)
Study of native and colored preparations	Neutrophils - 2-4%, lymphocytes - 60 ± 20%, monocytes - 30 ± 10%, eosinophils and ependymocytes - rarely

Bacterioscopic examination of cerebrospinal fluid

Bacterioscopic examination with the coloring of smears from the cystic sludge according to Tsiol-Nielsen is carried out with suspicion of tuberculous meningitis. Smears are prepared from the sediment of the CSF after centrifugation and from the fibrinous film formed when the fibrin is folded into which the mycobacterium tuberculosis is captured. Prepared smears are painted according to Tsil-Nielsen. Mycobacterium tuberculosis is more often found in fresh cases of the disease (in 80% of patients with tuberculous meningitis). In the case of negative or questionable results, a bacteriological study is necessary.

[1], [2], [3], [4], [5], [6], [7], [8], [9]