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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]
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]
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]
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 ...
Paravascular spaces are CSF-filled channels formed between the brain blood vessels and leptomeningeal sheathes that surround cerebral surface vessels and proximal penetrating vessels. Around these penetrating vessels, paravascular spaces take the form of Virchow-Robin spaces. Where the Virchow-Robin spaces terminate within the brain parenchyma ...
The most definitive diagnostic modality is a biopsy of the affected blood vessel however brain biopsy has a low yield, with up to 30-50% of biopsies being normal in suspected cases. [5] This is due to some cases having an irregular distribution of vessel involvement (making biopsy technically difficult) or larger vessels being unable to be ...
The CSF sample is examined for presence and types of white blood cells, red blood cells, protein content and glucose level. [8] Gram staining of the sample may demonstrate bacteria in bacterial meningitis, but absence of bacteria does not exclude bacterial meningitis as they are only seen in 60% of cases; this figure is reduced by a further 20% ...