Cerebrospinal fluid (CSF), Body Fluid in Dehradun

What is a Cerebrospinal fluid (CSF), Body Fluid?

Cerebrospinal fluid surrounds the brain and spinal cord, and analysing it is the definitive way to diagnose meningitis. It is normally crystal clear with almost no cells, a modest protein level and a glucose around two-thirds of the blood value, and the pattern of departure from that identifies the cause with considerable precision. Bacterial meningitis produces turbid fluid with a high neutrophil count, high protein and a characteristically very low glucose, because bacteria consume it. Viral meningitis produces a lymphocyte predominance with a normal or near-normal glucose, and is generally far less dangerous. Tuberculous meningitis, which remains important in India, produces lymphocytes with a high protein and a low glucose, developing over weeks rather than hours, and it is often supported by a raised ADA and a molecular test on the same sample. Fungal meningitis has its own pattern. Because bacterial meningitis can kill within hours, treatment is generally started immediately on suspicion, before results return, and the analysis then refines it rather than initiating it.

Why take this test?

CSF analysis is indicated where meningitis or another central nervous system infection is suspected: fever with severe headache, neck stiffness, discomfort in bright light, vomiting, drowsiness, confusion, seizures or a rash. In an infant the signs are subtler and more urgent, including poor feeding, irritability, an abnormally high-pitched cry, a bulging fontanelle, or unusual drowsiness. It is also used to investigate suspected bleeding around the brain when imaging is inconclusive, certain inflammatory neurological conditions, and suspected spread of cancer to the meninges. The fluid is obtained by lumbar puncture, a procedure performed by a doctor after assessment and often after imaging. This is emphatically not a test to arrange yourself or to wait on: suspected meningitis is a medical emergency, and anyone with fever and severe headache with neck stiffness, drowsiness or confusion should go to a hospital immediately.

• Fever with severe headache, neck stiffness or light sensitivity
• Drowsiness, confusion or seizures with fever
• An infant with poor feeding, irritability or a bulging fontanelle
• Suspected tuberculous meningitis developing over weeks
• Suspected bleeding around the brain when imaging is inconclusive
• Suspected inflammatory neurological disease or meningeal spread of cancer

FAQs: Cerebrospinal fluid (CSF), Body Fluid in Dehradun