Cerebrospinal fluid (CSF) test

Cerebrospinal fluid is a clear, colorless liquid located in the ventricles and spinal cord, which acts as a cushion to protect the brain and spine after an injury. The cerebrospinal fluid test is a test done to check the condition of this fluid and helps measure the pressure in the cerebrospinal fluid, which helps diagnose brain diseases.

1.1 What is cerebrospinal fluid and where is it produced? Cerebrospinal fluid (CSF) is a clear, colorless fluid produced from the choroid plexus of the ventricles. Small amounts of cerebrospinal fluid are also produced by epithelial cells. The total volume of cerebrospinal fluid in adults ranges from 140-270 ml. The volume of the ventricles is about 25ml. Cerebrospinal fluid is generated at a rate of 0.2-0.7ml/min or 600-700ml/day. The circulation of the cerebrospinal fluid is aided by the impulses of the choroid plexus and the movement of the cilia of the epithelial cells.
Cerebrospinal fluid is absorbed through the arachnoid villi into the venous circulation and a significant amount may also drain into the lymphatic vessels surrounding the cranial cavity and spinal canal. The arachnoid villi act as a one-way valve between the subarachnoid space and the dural space. The rate of absorption corresponds to the pressure of the cerebrospinal fluid.
1.2 Function of CSF The cerebrospinal fluid has the function of maintaining a stable pressure for the ventricular system because the brain has a considerable volume (about 1400g) and has many wrinkles. However, because cerebrospinal fluid surrounds the brain, it dissipates a lot of the downward force that normally acts on the organ. This helps reduce stress on the brain and allows the brain to maintain its shape.
Another function of cerebrospinal fluid comes from its physical nature as a fluid, so it protects the brain from damage that can result from sudden skull movements. Any rapid deceleration or acceleration of the head has the potential to damage brain cells. Cerebrospinal fluid helps reduce damage in such a case by acting as a buffer and shock absorber.
Since cerebrospinal fluid is continuously produced and absorbed, it helps to remove waste products from around the brain and regulate intracranial pressure. This process can be controlled by decreasing or increasing production to match the needs of the central nervous system at any given time. Regulates circulatory flow to brain tissue and reduces central nervous system ischemia.

2.1 Purpose of CSF testing CSF testing is performed for the purpose of diagnosing infectious diseases of the brain and spinal cord such as meningitis and encephalitis. The csf test in case of an infection looks at bacteria, white blood cells, and other substances present in the cerebrospinal fluid. In addition, tests of cerebrospinal fluid for disorders look for high levels of certain proteins contained therein and called albumin and IgG/albumin proteins, in the diagnosis of autoimmune disorders such as syndromes Guillain-Barré and multiple sclerosis.
In addition, the CSF test is also performed in the diagnosis of a number of other conditions such as:
Bleeding in the brain Brain tumors Suspicious of brain, spinal cord infection or autoimmune disorders People with brain or spinal cord injury or have been diagnosed with cancer that has spread to the brain or spinal cord. 2.2 How is the cerebrospinal fluid test performed? Cerebrospinal fluid is obtained by lumbar puncture or suboccipital puncture in cases of spinal cord compression or lumbar puncture for any other reason. CSF sampling must be performed by an experienced physician and must be performed in a dry, sterile environment. After being collected, the cerebrospinal fluid sample should be immediately transferred to the laboratory for analysis.
Cerebrospinal fluid is a clear liquid, so any change in color can help the doctor get an initial diagnosis of the condition. Normal CSF from the lumbar region functions 50-80ml/dl glucose (2⁄3 blood glucose) and 15-45mg/dl protein (lower in children). Protein concentrations in the cerebrospinal fluid and ventricles are lower. Cerebrospinal fluid also contains mononuclear cells. CSF pressure measured at lumbar puncture is 100-180mmH2O (8-15mmHg) with the patient supine and 200-300mmH2O when the patient is sitting.
2.3 Test results of cerebrospinal fluid A sample of cerebrospinal fluid can determine the cause and help doctors orientate in the diagnosis of diseases that the patient has such as:
Blood: cerebrospinal fluid is slightly red More or less depends on the amount of blood present in the fluid, common in diseases such as brain injury, subarachnoid hemorrhage, cerebral - meningeal hemorrhage. Inflammatory cells increase: inflammatory cells such as leukocytes are found in viral infections (meningitis, aseptic meningitis), meningitis, tuberculosis, multiple sclerosis, syphilis, neurosyphilis, brain abscesses and brain tumors. Tumor cells: Foreign cells (malignant cells) appear in the cerebrospinal fluid, suggestive of local or metastatic cancerous conditions. Increased protein: protein is increased in bacterial meningitis, cerebrospinal fluid protein may increase to 500 mg/dl. Moderate increases (150-200 mg/dl) occur in meningitis, encephalitis, intracranial tumours, cerebral infarction, and subarachnoid hemorrhage. A more severe protein elevation occurs in Guillain-Barré syndrome, schwannoma, and spine. In multiple sclerosis, cerebrospinal fluid protein is normal or slightly elevated, but there is often an increase in CSF IgG, but not serum, as indicated by an increase in the IgG/albumin index of cerebrospinal fluid (usually 10:1). Low glucose in cerebrospinal fluid is seen in suppurative infections, sarcoidosis, tuberculosis, fungal and disseminated meningiomas. Glucose is consumed by tumor cells and white blood cells. In summary, the cerebrospinal fluid test is a test performed to check the status of this fluid and help measure the pressure in the cerebrospinal fluid, helping to diagnose brain diseases such as encephalitis, meningitis, multiple encephalitis. sclerosis, ... When the patient has symptoms of brain disease, the doctor will order a test of the cerebrospinal fluid to find the cause and evaluate the medical condition.
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