Spinal tap; Ventricular puncture; Lumbar puncture; Cisternal puncture; Cerebral spinal fluid culture

Normal values typically range as follows:

• Pressure: 70 - 180 mm H20
• Appearance: clear, colorless
• CSF total protein: 15 - 60 mg/100 mL
• Gamma globulin: 3 - 12% of the total protein
• CSF glucose: 50 - 80 mg/100 mL (or greater than 2/3 of blood sugar level)
• CSF cell count: 0 - 5 white blood cells (all mononuclear), and no red blood cells
• Chloride: 110 - 125 mEq/L

Note: mg/mL = milligrams per milliliter; mEq/L = milliequivalents per liter

Note: Normal value ranges may vary slightly among different laboratories. Talk to your doctor about the meaning of your specific test results.

If the CSF looks cloudy, it could mean there is an infection or a build up of white blood cells or protein.

If the CSF looks bloody or red, it may be a sign of bleeding or spinal cord obstruction. If it is brown, orange, or yellow, it may be a sign of increased CSF protein or previous bleeding (more than 3 days ago). Occasionally, there may be blood in the sample that came from the spinal tap intself. This makes it harder to interpret the test results.

Increased CSF pressure may be due to increased intracranial pressure (pressure within the skull). Decreased CSF pressure may be due to spinal cord tumor, shock, fainting, or diabetic coma.

Increased CSF protein may be due to blood in the CSF, diabetes, polyneuritis, tumor, injury, or any inflammatory or infectious condition. Decreased protein is a sign of rapid CSF production.

Increased CSF gamma globulin levels may be due to diseases such as multiple sclerosis, neurosyphilis, or Guillain-Barre syndrome.

Increased CSF glucose is a sign of high blood sugar. Decreased CSF glucose may be due to hypoglycemia (low blood sugar), bacterial or fungal infection (such as meningitis), tuberculosis, or certain other types of meningitis.

Increased white blood cells in the CSF may be a sign of meningitis, acute infection, beginning of a chronic illness, tumor, abscess,stroke, or demyelinating disease (such as multiple sclerosis).

Red blood cells in the CSF sample may be a sign of bleeding into the spinal fluid or the result of a traumatic lumbar puncture.

Additional conditions under which the test may be performed:

• Chronic inflammatory polyneuropathy
• Dementia due to metabolic causes
• Encephalitis
• Epilepsy
• Febrile seizure (children)
• Generalized tonic-clonic seizure
• Hydrocephalus
• Inhalation anthrax
• Normal pressure hydrocephalus (NPH)
• Pituitary tumor
• Reye syndrome

Images

CSF chemistry

Lumbar vertebrae

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Cerebral spinal fluid (CSF) collection Overview

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Cerebral spinal fluid (CSF) collection Risks

Review Date: 06/24/2009
Reviewed By: David C. Dugdale, III, MD, Professor of Medicine, Division of General Medicine, Department of Medicine, University of Washington School of Medicine; Daniel B. Hoch, PhD, MD, Assistant Professor of Neurology, Harvard Medical School, Department of Neurology, Massachusetts General Hospital. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.

A.D.A.M., Inc. is accredited by URAC, also known as the American Accreditation HealthCare Commission (www.urac.org)