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Reference ranges for other CSF constituents Substance Lower limit Upper limit Unit Corresponds to % of that in blood plasma; RBCs: n/a [2] 0 [2] / negative: cells/μL or cells/mm 3: WBCs: 0 [2] 3 [2] cells/μL cells/mm 3: pH: 7.28 [1] 7.32 [1] (-log M) PCO 2: 44 [1] 50 [1] mmHg 5.9 [7] 6.7 [7] kPa: PO 2: 40 [1] 44 [1] mmHg 5.3 [7] 5.9 [7] kPa
[34] [36] The presence of red blood cells and xanthochromia may indicate subarachnoid hemorrhage; whereas central nervous system infections such as meningitis, may be indicated by elevated white blood cell levels. [36] A CSF culture may yield the microorganism that has caused the infection, [34] or PCR may be used to identify a viral cause. [36]
Acid–base and blood gases are among the few blood constituents that exhibit substantial difference between arterial and venous values. [6] Still, pH, bicarbonate and base excess show a high level of inter-method reliability between arterial and venous tests, so arterial and venous values are roughly equivalent for these. [44]
It may also be used to detect the presence of malignant cells in the CSF, as in carcinomatous meningitis or medulloblastoma. CSF containing less than 10 red blood cells (RBCs)/mm 3 constitutes a "negative" tap in the context of a workup for subarachnoid hemorrhage, for example. Taps that are "positive" have an RBC count of 100/mm 3 or more. [9]
For example, an increase in lesion volume (e.g., epidural hematoma) will be compensated by the downward displacement of CSF and venous blood. [24] Additionally, there is some evidence that brain tissue itself may provide an additional buffer for elevated ICP in circumstances of acute intracranial mass effect via cell volume regulation. [25] [26]
Under normal conditions, there are usually less than 5 white blood cells per μL of CSF. In a pleocytic setting, the number of lymphocytes can jump to more than 1,000 cells per μL. Increases in lymphocyte count are often accompanied by an increase in cerebrospinal protein concentrations in addition to pleocytosis of other types of white blood ...
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The majority of the CSF is formed in the choroid plexus and flows through the brain along a distinct pathway: moving through the cerebral ventricular system, into the subarachnoid space surrounding the brain, then draining into the systemic blood column via arachnoid granulations of the dural sinuses or to peripheral lymphatics along cranial ...