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19 Cards in this Set
- Front
- Back
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Total volume of CSF? |
150 mL |
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Normal resting pressure of CSF? |
Between 150 and 180 mm H2O; varies from 65 mm H2O to 200 mm H2O |
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Major cause of error in measurement? |
Failure to position the patient in lateral decubitus, where the right atrium pressure can serve as the reference 0 |
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Which four main CSF variables are examined? |
1. Glucose (relative to serum glucose) 2. Quantity and type of red and white blood cells 3. CSF protein level 4. Opening pressure |
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Typical CSF findings in bacterial infections? |
>100 mg/dL protein, <40% glucose, >500 WBC, predominantly PMNs |
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Typical CSF findings in viral infections? |
<120 mg/dL protein, >40% glucose, 10-500 cells, lymphocytes |
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Typical CSF findings in granulomatous disease? |
>50 mg/dL protein, <40% gluocse, 10-1000 cells, lymphocytes |
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What difference in glucose between serum and CSF in diabetic patients should be considered abnormal? |
A CSF to serum ratio of glucose less than 30%; ideally, the serum glucose value should be measured 1 hour before LP to account for CSF glucose equilibration |
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A low glucose value in the CSF (hypoglycorrhachia) may be indicative of what? |
CNS infection, inflammation, or other meningeal reactive processes |
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A low glucose value in bacterial meningitis is thought to be a result from what? |
Shutdown of the glucose transporter system. Leukocyte utilization contributes to a lesser extent, but bacterial consumption does not contribute. |
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What is the low CSF protein count a result of? |
Blood brain barrier, and the gradient is thus large. CSF protein increase reflects the degree of impairment of the blood-brain barrier |
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What is Froin syndrome? |
CSF with a very high protein value and xanthochromia, resulting in spinal fluid that spontaneously coagulates |
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Usually, Froin syndrome is due to what? |
Loculation of the CSF in portions of the subarachnoid space, where spinal fluid circulation is compromised by an inflammatory or neoplastic obstruction |
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Clotting of CSF is due to? |
Leakage of fibrinogen and other clotting factors from the serum |
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Causes of a very increased CSF protein value (>500 mg/dL)? (5) |
1. TB meningitis 2. Spinal block 3. Subarachnoid hemorrhage 4. Inflammatory polyneuropathy 5. Meningeal involvement by a malignancy |
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Causes of xanthochromia? |
1. Oxyhemoglobin - 4-6 hours after bleeding 2. Bilirubin - 2 days after bleeding |
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How is the CSF igG index calculated? |
(CSF IgG / Serum IgG) / (CSF albumin / serum albumin) = CSF IgG index |
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Hallmark CSF finding in inflammatory polyradiculopathies? |
"Cytoalbuminologic dissociation", which reflects an increased CSF protein value in the setting of a normal CSF WBC count. However, up to 10% of patients may have normal CSF protein value |
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CSF obtained directly from ventricles have a higher or lower glucose value than CSF from the lumbar sac? |
Always higher glucose value in the ventricles |
