Cerebral spinal fluid (CSF) collection Health Article

What abnormal results mean

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).

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 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 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

What the risks are

Risks of lumbar puncture include:

• Hypersensitivity (allergic) reaction to the anesthetic
• Discomfort during the test
• Headache after the test
• Bleeding into the spinal canal

There is an increased risk of bleeding in persons who take blood thinners.

Brain herniation may occur if this test is done on a person with a mass in the brain (such as a tumor or abscess). This can result in brain damage or death. This test is not done if an exam or test reveals signs of a brain mass.

Damage to the nerves in the spinal cord may occur, particularly if the person moves during the test.

Cisternal puncture or ventricular puncture carry additional risks of brain damage and bleeding within the brain.

Special considerations

This test should not be performed on people who may have increased intracranial pressure.

References

Nathan, BR. Cerebrospinal Fluid and Intracranial Pressure. In: Goetz, CG, ed. Textbook of Clinical Neurology, 2nd ed. Philadelphia, Pa:WB Saunders Company; 2003:511-524.