CSF Analysis

CSF Analysis, CSF refers to cerebrospinal fluid, which is called cerebrospinal fluid. This fluid is released from the choroid plexuses in the brain’s ventricle and then in the subarachnoid space of the brain and cerebrum. At the same time, with the help of Anconoid Villi, it continues to be absorbed into the blood of the Dural sinuses and this process continues due to which the amount of CSF cannot increase.

A section called the Blood Brain Barrier between the blood and the CSF allows some substances to enter the CSF and not others. When the membrane of the brain is inflamed or a certain disease occurs, it stops working.

• CSF acts as a shock absorber for the brain and protects the brain from damage in the event of a head injury or severe shock.
• CSF powers the brain, resides in the brain space, and maintains its overall volume.

Color and Nature:

CSF is a colorless and clear liquid. If CSF is allowed to stand for a long time, it does not form any kind of mesh, no membrane is formed. It contains 1-5 lymphocytes.

Protein:

Protein in CSF is 20-45 mg per 100 ml and increases in disease.

Glucose:

Its amount is 80 – 40 mg per 100 ml. Under normal conditions, the amount of glucose in the blood is two-thirds of the amount in CSF. Its quantity decreases in various diseases but its quantity remains normal in viral diseases. When testing glucose in CSF, glucose is also tested in blood.

Chloride:

Its normal concentration is 127 – 118 mmol/L. It is of little importance and therefore rarely tested.

Obtaining a CSF sample:

A CSF sample is obtained from the spinal cord using a special needle to collect CSF from the space between the 11th and 12th lumbar vertebrae. This needle is called a lumber puncture needle. To obtain this sample, three are obtained in a clean tube, and about 2 to 3 ml of CSF is added to each the needle is then withdrawn, and all three It is sent to the laboratory.

It is usually the case that blood is mixed with the sample obtained in the first tube. So it is not commonly used. The second tube is used for chemical and microbiological examination and the CSF from the third tube is used for culture while the remaining amount of CSF is stored in the refrigerator and checked two hours later. If no membrane is formed, if so, it means that it contains the TB germ.

Physical Examination:

Color:

Its color is seen in it. The color of this liquid is like water, if the color is yellow, then it is a sign of disease, such a condition can be caused by the breakdown of the brain, and R.B.C. and such a condition can also occur in jaundice. Red color means that there is blood in it and it can also happen in the case of rupture of a vein in the brain. If there are more cells in it, its color becomes darker. does.

Cell Count:

For cell counting, focus the New Bar chamber by placing a water glass in the microscope at 10 power. Now turn off the light of the microscope. is filled. After about 2 minutes, it is placed in the microscope, the light is turned on, and it is seen through fine focus. is multiplied by 10. The answer will be the total cells present in a cubic milliliter written as TOTAL CELL = 1-/CU.MM.
If it is suspected that it contains R.B.C., a drop of hydrochloric acetic acid is added to one side, thus dissolving the R.B.C. and leaving only W.B.C. remains.

Prepare a CSF Smear:

This requires 2 to 3 cc of CSF. CSF is put into a test tube and centrifuged. From the deposit thus obtained a slide is prepared in the usual manner and dried. Three slides are made by this method. A slide is stained with Leishman Stain. With its help, we observe the presence and type of germs in it. This can lead to knowledge about TB. The type and number of WBCs are determined.

Bi-Urate Method for Protein:

The following items are required for this purpose:

1. Sodium Hydroxide 15%
2. Trichloroacetic acid 10%
3. Copper Sulphate 5%

• For this, 2 ml of CSF is taken, 2 ccs of 10% trichloroacetic acid are added to it, shaken, and allowed to stand for 5 minutes. It is then centrifuged, the supernatant is discarded and the test tube is labeled T.
• Another test tube is taken and 10% trichloroacetic acid is added to it and marked with a B mark i.e. Blank.
• Now one milliliter of 15% sodium hydroxide is added to these two tubes and the tube is shaken to dissolve the sediments. After that, half a milliliter of 50% persulfate is added inside these tubes and centrifuged by adding 4 milliliters of water.
• The top portion is poured into two separate tubes marked T and B. Now zero the calorimeter by applying a 550 filter first from B and then find the reading from T.
• Now another tube ST standard is used in which CSF is replaced with a known quantity of protein solution obtained from the prepared market and its reading is determined with a calorimeter.

Determining the amount of Globulin:

For this test, a solution is prepared by dissolving 10 grams of Festool in 150 ml of distilled water.

Method:

2 ml of Pandys Reagent is taken in a test tube and two drops of CSF are added to it. If there is even a slight change in the transparency of the tube, it indicates an increased amount of globulin.

To Detect Glucose:

This is done in the same way as for blood sugar, if the CSF contains blood or turbidity, clear it by centrifugation and test the upper part.

Culture of CSF:

In case of an infection, a culture is done for bacterial information. By doing this, the right support for the germs can be selected.

Normal values of CSF:

• Pressure 70 – 150 ml
• Amount 90 to 150 ml
• Density 1.006 to 1.008

CSP Pressure:

CSF pressure becomes higher than normal in the case of the following diseases.

• If the brain artery bursts (Brain hemorrhage), then this pressure increases.
• A brain injury increases its pressure.
• Cerebral edema increases its pressure.
• This pressure can increase due to brain tumors.
• This pressure can increase due to inflammation of the membranes of the brain.

Turbidity of CSF:

CSF is a clear liquid, but it can become cloudy for the following reasons:

• In inflammation of the brain, it may become cloudy.
• Inflammation of the meninges can confuse.
• It may be cloudy in case of TB of the brain.
• In Neisseria Meningitis it may be cloudy.
• In the case of Hemophilic influenza, it may be cloudy.
• Pneumococci can cause it to become cloudy.
• Streptococci can cause it to become cloudy.
• Staphylococci can cause it to become cloudy.
• It can become cloudy due to coliforms.

Increased Protein in CSF:

As we have mentioned the normal amount of protein in CSF is 45 – 20 mg per 100 ml and also described the test for protein, now we will explain the reasons for increased protein in CSF. In the following cases, the protein is increased from normal.

• Proteinuria is increased due to viral meningitis.
• Bacterial meningitis increases the amount of protein.
• Bacterial mango encephalitis causes proteinuria.
• It is increased by A. septic meningitis.
• Brain tumors increase their amount.

Elevation of Glucose in CSF:

The normal amount of glucose in CSF is 80-40 mg per 100 ml and the method of its test has also been described.

• It increases with viral meningitis.
• Brain tumors increase their amount.