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Cerebrospinal Fluid ExaminationAka: CSF Exam, Cerebrospinal Fluid Abnormality

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  1. See Also
    1. Lumbar Puncture
    2. Nigrovic Clinical Decision Rule
  2. Findings: Normal
    1. CSF Color: Clear
    2. CSF Glucose
      1. Children and Adults: 50-80 mg/dl
      2. Normal newborn: >60% of simultaneous Serum Glucose
      3. Normal infant: >50% of simultaneous Serum Glucose
    3. CSF Protein
      1. Children and Adults: 20-45 mg/dl
      2. Normal term newborn: <70 mg/dl
      3. Normal term newborn: <40 mg/dl
    4. CSF Chloride 116-122
    5. CSF Opening Pressure 100-200
    6. CSF Leukocytes
      1. No Neutrophils and under 6 Lymphocytes
      2. Normal term newborn: <10 WBCs/ml (<10% Neutrophils)
  3. Findings: Bacterial Meningitis
    1. See Nigrovic Clinical Decision Rule
    2. CSF Color: Cloudy CSF
    3. CSF Glucose much less than 50
    4. CSF Protein much greater than 45
    5. CSF Leukocytes: Markedly increased Neutrophils
    6. CSF Opening Pressure: increased >200
  4. Findings: Viral Meningitis
    1. CSF Color: Clear to Cloudy Fluid
    2. CSF Glucose: Normal
    3. CSF Protein > 45
    4. CSF Leukocytes: Increased CSF Lymphocytes
    5. CSF Opening Pressure: Normal or increased
  5. Findings: Fungal Meningitis
    1. CSF Color: Clear to Cloudy Fluid
    2. CSF Glucose < 50
    3. CSF Protein > 45
    4. CSF Leukocytes: Monocytes increased
    5. CSF Opening Pressure: Increased
  6. Findings: Tuberculosis Meningitis
    1. CSF Color: Cloudy Fluid
    2. CSF Glucose < 50
    3. CSF Protein > 45
    4. CSF Leukocytes
      1. Early: Neutrophils increased
      2. Later: Lymphocytes increased
  7. Findings: Intracranial Hemorrhage
    1. CSF Color: Bloody CSF with xanthochromia
    2. CSF Glucose: Normal or decreased
    3. CSF Protein: >45
    4. CSF Red Blood Cells: Increased
    5. CSF Opening Pressure: Increased >200
  8. Findings: Neoplasm
    1. CSF Color: Clear or xanthochromic
    2. CSF Glucose: Normal or decreased
    3. CSF Protein: Normal or increased
    4. CSF Leukocytes: Normal or increased Lymphocytes
    5. CSF Opening Pressure: Increased >200
  9. Findings: Neuro-Syphilis
    1. CSF Color: Clear to cloudy fluid
    2. CSF Glucose: Normal
    3. CSF Protein: >45
    4. CSF Leukocytes: Monocytes increased
    5. CSF Opening Pressure: Normal or increased
  10. Findings: Guillain-Barre
    1. CSF Color: Clear to cloudy fluid
    2. CSF Glucose: Normal
    3. CSF Protein much greater than 45
    4. CSF Leukocytes: Lymphocytes normal or increased
    5. CSF Opening Pressure: Normal
  11. References
    1. Kooiker in Roberts (1998) Procedures in ER, p. 1067-75
    2. Ravel (1995) Lab Medicine, Mosby, p. 294-9
    3. Tunkel in Mandell (2000) Infectious Disease, p. 974-8
    4. Griffith (1994) Neurol Clin 12:541
    5. Seehusen (2003) Am Fam Physician 68:1103

[D]Cerebrospinal fluid abnormality (C0151583)

ConceptsFinding (T033)
ICD9792.0
EnglishABN FND-CEREBROSPINAL FL, CEREBROSPINAL FLUID ABNORMAL, CSF ABNORMAL, Nonspecific abnormal findings in cerebrospinal fluid, SPINAL FLUID ABNORM
Parent ConceptsCerebrospinal Fluid (C0007806), CNS GENERAL (C0549638), Other nonspecific abnormal findings in body substances (C0159079), [D]Nonspecific findings in other body substances (C0476345), Duplicate concept (C1274013)
SourcesCST, ICD9CM, SCTSPA, SNOMEDCT
Derived from the NIH UMLS (Unified Medical Language System)



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