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Froin's syndrome – coexistence of xanthochromia, high protein level and marked coagulation of cerebrospinal fluid (CSF). It is caused by meningeal irritation (e.g. during spinal meningitis) and CSF flow blockage by tumour mass or abscess. [1]
Lymphocytic pleocytosis is an abnormal increase in the amount of lymphocytes in the cerebrospinal fluid (CSF). It is usually considered to be a sign of infection or inflammation within the nervous system , and is encountered in a number of neurological diseases , such as pseudomigraine, Susac's syndrome, and encephalitis.
A positive test shows a bluish-white streak of precipitated proteins. The degree of turbidity depends on the amount of protein in the CSF. It can vary from faint turbidity (mild to moderate elevation in CSF proteins) to dense milky precipitate (high protein content in CSF).
Ferritin, an iron storage protein, is over-produced in response to excess heme by glial cells in order to sequester iron, with production ranging from 20.1 to 27.4 times normal levels. Excess iron, ferritin, and red blood cells may result in xanthochromia of the cerebrospinal fluid.
Any CSF leak is most often characterized by orthostatic headaches, which worsen when standing, and improve when lying down. Other symptoms can include neck pain or stiffness, nausea, vomiting, dizziness, fatigue, and a metallic taste in the mouth. A CT myelography scan can identify the site of a cerebrospinal fluid leakage.
Incidence is estimated to 0.3–3% in patients older than 60 years and raising with older age. [38] Its prevalence is reported to be less than 1% in persons under the age of 65, and up to 3% for persons aged 65 or older. No difference in incidence is seen between men and women or amongst differing ethnicities.
CT or MRI may show cortical atrophy or white matter lesions. CSF examination usually reveals normal pressure, cell count, and total protein content; however, CSF globulin is almost always elevated, constituting up to 20 to 60% of CSF protein. Serum and CSF contain elevated levels of measles virus antibodies.
When collecting CSF for suspected TB meningitis, a minimum of 1 ml of fluid should be taken (preferably 5 to 10 ml). [10] [11] The CSF usually has a high protein, low glucose and a raised number of lymphocytes. Acid-fast bacilli are sometimes seen on a CSF smear, but more commonly, M. tuberculosis is grown in culture. [12]