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Analysis of the liquor

 
, medical expert
Last reviewed: 05.07.2025
 
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Liquor (cerebrospinal fluid) is formed in the ventricles of the brain by the sweating of 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 cisterns of the brain and the subarachnoid space. From 400 to 600 ml of liquor is formed per day.

The study (analysis) of cerebrospinal fluid has an important diagnostic value in 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, cerebrovascular accidents, tumors, and injuries.

General clinical examination of cerebrospinal fluid includes a study of its physicochemical properties and cellular composition.

Reference indicators (norm) of cerebrospinal fluid

Characteristics

Indicators

Color

Colorless

Transparency

Complete

Density:

At lumbar puncture

1,006-1,007

During ventricular puncture

1,002-1,004

Reaction

Weakly alkaline

Protein:

At lumbar puncture

0.2-0.3 g/l

During ventricular puncture

0.1-0.22 g/l

Globulin reactions:

Pandy's reaction

Negative

Nonet-Apelt reaction

Negative

Glucose:

At lumbar puncture

2.8-3.9 mmol/l

During ventricular puncture

2.8-3.9 mmol/l

Chlorides:

At lumbar puncture

120-130 mmol/l

During ventricular puncture

120-130 mmol/l

Cytosis:

At lumbar puncture

7-10 cells/3 µl (2-3×10 6 /l)

During ventricular puncture

0-3 cells/3 µl (0-1×10 6 /l)

Study of native and stained preparations

Neutrophils - 2-4%, lymphocytes - 60±20%, monocytes - 30±10%, eosinophils and ependymocytes - rare

Bacterioscopic examination of cerebrospinal fluid

Bacterioscopic examination with staining of smears from the cerebrospinal fluid sediment according to Ziehl-Neelsen is carried out if tuberculous meningitis is suspected. Smears are prepared from the cerebrospinal fluid sediment after centrifugation and from the fibrinous film formed during fibrin coagulation, in which mycobacteria tuberculosis are captured. The prepared smears are stained according to Ziehl-Neelsen. Mycobacteria tuberculosis are more often detected in fresh cases of the disease (in 80% of patients with tuberculous meningitis). In case of negative or questionable results, bacteriological examination is necessary.

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