Читать книгу Neurology - Charles H. Clarke - Страница 160

Principal indications are:

 Suspected meningitis and encephalitis – in some cases

 Suspected subarachnoid haemorrhage – blood products

 Pressure measurement (e.g. idiopathic intracranial hypertension)

 Therapeutic CSF removal (e.g. idiopathic intracranial hypertension)Table 4.3 Normal CSF.ObservationCommentAppearanceCrystal clear, colourlessClear when held to light, a.k.a. ‘gin clear’Pressure60–150 mm CSFPatient must be relaxed, recumbent with needle patent for CSF to oscillate in manometerCell count<5/mm3.No polys: mononuclears onlyProtein0.2–0.4 g/LSlightly raised protein <0.7 g/L rarely pathologicalGlucose⅔ to ½ of blood glucoseCSF glucose <½ blood glucose suspiciousCultureSterileDo not accept contaminantsIgG<15% of total CSF proteinUsually only on requestOligoclonal bandsAbsentParallel blood sample

 Assays in MS, neurosyphilis, sarcoidosis, Behçet’s, chronic infection, malignant meningitis, polyneuropathy & some dementias.

 Intrathecal contrast injection and drugs.

In suspected CNS infection, meticulous attention should focus on examination for cells, cell types and microbiological tests.