The rates of cerebrospinal fluid in diseases

Xanthrome coloration (yellow, yellow-gray, yellow-brown, green) appears with jaundice; tumors of the brain, rich in blood vessels and close to the cerebrospinal fluid; cysts; subarachnoidal administration of large doses of penicillin; in newborns this color is physiological in nature.

Red color (erythrochromia) gives the CSF unchanged blood, which can appear as a result of trauma, hemorrhage.

Dark-cherry or dark-brown color is possible with hematomas and liquid liquor from the cysts.

Opacity of CSF is possible with purulent meningitis, breakthrough of abscess into subarachnoid space, poliomyelitis, tuberculosis and serous meningitis (the appearance of turbidity immediately or after standing of liquid during the day). Inflammatory processes of the meninges shift the pH to the acid side.

An increase in protein in the cerebrospinal fluid can be with tuberculosis, purulent, serous meningitis, hemodynamic disorders, after brain operations, brain tumors, poliomyelitis, brain trauma with subarachnoid hemorrhage, nephritis with uremia. In acute inflammation, a-globulins increase, in the case of chronic inflammations, beta- and y-globulins.

The positive reactions of Pandi and Nonne Apelt indicate an increased content of the globulin fraction and accompany cerebral hemorrhages, brain tumors, meningitis of various origins, progressive paralysis, dorsal and multiple sclerosis. Admixture to the blood liquor always gives positive globulin reactions.

Changes in glucose levels in cerebrospinal fluid in various diseases

Increase in glucose concentration	Decreased glucose concentration
Encephalitis	Meningitis:
Tumors of the brain	Tubercular;
Syphilis of the central nervous system	Streptococcal;
Diabetes	Meningococcal and others.
Thetania and tetanus (sometimes)	Tumors of the pia mater

Chloride content change in cerebrospinal fluid for various diseases

Increase in chloride concentration	Decrease in chloride concentration
Tumors of the brain	Tuberculosis and other bacterial meningitis
Abscesses
Echinococcus
Multiple sclerosis
Uremia
Nephritis
Progressive paralysis

Pleocytosis is an increase in the number of cells in the cerebrospinal fluid. Minor pleocytosis is possible with progressive paralysis, syphilis, specific meningitis, arachnoiditis, encephalitis, multiple sclerosis, epilepsy, tumors, trauma to the spine and brain. Massive pleocytosis is observed in acute purulent meningitis, an abscess.

Lymphocytic pleocytosis is observed in the postoperative period with neurosurgical operations, chronic inflammation of the brain membranes (tubercular meningitis, cysticercosis arachnoiditis), viral, syphilitic, fungal meningoencephalitis. Moderate pleocytosis with a predominance of lymphocytes is possible when the pathological process is localized in the depth of the brain tissue. Unchanged neutrophils are observed when fresh blood enters the cerebrospinal fluid during operations on the brain, with acute inflammation; altered neutrophils - with the attenuation of the inflammatory process. The combination of unchanged and altered neutrophils indicates an exacerbation of inflammation. A sharp appearance of a large neutrophilic pleocytosis is possible when an abscess breaks into liquor spaces. At a poliomyelitis in the beginning of disease neutrophils prevail, and then lymphocytes.

Changes in cerebrospinal fluid characteristics, characteristic of bacterial, viral, fungal and tubercular meningitis

	Type of meningitis
Index	Bacterial	Viral	Fungal / tubercular
The number of leukocytes, x10 6 / l	More than 500	Less than 500	Less than 500
The neutrophil count,%	More than 80	Less than 50	Less than 50
Glucose, mmol / l	Less than 2.2	More than 2,2	Less than 2.2
Lactate, mmol / l	More than 4,0	Less than 2.0	More than 2.0
Protein, g / l	More than 1.0	Less than 1.0	More than 1.0

Eosinophils are detected with subarachnoid hemorrhages, toxic, reactive, tubercular, syphilitic, epidemic meningitis, tumors, cysticercosis of the brain.

Plasma cells are found in encephalitis, tuberculous meningitis, sluggish wound healing after surgery.

Macrophages are detected in normal cytosis after bleeding and in the inflammatory process. A large number of macrophages in the cerebrospinal fluid can be detected during its sanation in the postoperative period. The absence of them in pleocytosis is a poor prognostic sign. Macrophages with droplets of fat in the cytoplasm (granular spheres) are present in the fluid from the brain cysts and with certain tumors (craniopharyngioma, ependymoma).

Epithelial cells are determined in neoplasms of the membranes, sometimes in the inflammatory process.

Cells of malignant tumors can be found in the cerebrospinal fluid of the brain with cancer metastases and melanoma in the cerebral cortex, subcortical areas, cerebellum; Blast cells - with neuroleukemia.

Erythrocytes appear in the cerebrospinal fluid with intracranial hemorrhages (in this case, not so much their absolute number as the increase in the re-examination is important).