Laboratory analysis of cerebrospinal fluid.
OBJECTIVE
To review the physiology of cerebrospinal fluid (CSF), normal laboratory reference values, and key aspects of CSF sample collection, gross and microscopic examination, microbiologic testing, and chemical analysis.


METHODS
Recent professional literature.


METHODS
Selected manually by the authors.


METHODS
Articles manually by the authors.


RESULTS
CSF is formed by a combined process of plasma ultrafiltration and active secretion.  Mechanical and osmotic barriers exist between plasma and CSF and between CSF and brain.  Lumbar puncture is the preferred technique for CSF sampling.  Normal CSF should be clear, colorless, and free of clotted material.  CSF can be examined for presence of microbes using stains.  Additionally, the chemical composition of CSF can be examined; tests of interest include glucose, protein, lactate, enzymes, glutamine, specific amino acids, biogenic amines, and various drugs.


CONCLUSIONS
Visual, microscopic, and chemical examination of CSF is essential to the clinical management of patients with CNS disease.
Smith
S V
SV
Department of Pathology, Division of Laboratory Medicine, School of Medicine, University of North Carolina, Chapel Hill 27599.
Forman
D T
DT
D002555:Cerebrospinal Fluid / Q000737:chemistry* / Q000502:physiology; D019411:Clinical Laboratory Techniques; D006801:Humans; D012016:Reference Values; D013048:Specimen Handling