Cerebrospinal Fluid Examination

Aka: Cerebrospinal Fluid Examination, CSF Exam, Cerebrospinal Fluid Abnormality

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II. Findings: Normal

  1. CSF Color: Clear
  2. CSF Glucose
    1. Children and Adults: 50-80 mg/dl
    2. Normal newborn: >60% of simultaneous Serum Glucose
    3. Normal infant: >50% of simultaneous Serum Glucose
  3. CSF Protein
    1. Children and Adults: 20-45 mg/dl
    2. Normal term newborn: <70 mg/dl
    3. Normal term newborn: <40 mg/dl
  4. CSF Chloride 116-122
  5. CSF Opening Pressure 100-200
  6. CSF Leukocytes
    1. No Neutrophils and under 6 Lymphocytes
    2. Normal term newborn: <10 WBCs/ml (<10% Neutrophils)

III. Findings: Bacterial Meningitis

  1. See Nigrovic Clinical Decision Rule
  2. CSF Color: Cloudy CSF
  3. CSF Glucose much less than 40% of Serum Glucose or 40 mg/dl (but normal in half of Bacterial Meningitis)
  4. CSF Protein >100 mg/dl
  5. CSF Leukocytes: Markedly increased Neutrophils
    1. WBC >100/mm3 in 99% of cases and >1000/mm3 in most cases
  6. CSF Opening Pressure: increased >200
  7. CSF Culture positive in 70% of cases

IV. Findings: Viral Meningitis

  1. CSF Color: Clear to Cloudy Fluid
  2. CSF Glucose: Normal
  3. CSF Protein > 45 (typically near normal)
  4. CSF Leukocytes: Increased CSF Lymphocytes
  5. CSF Opening Pressure: Normal or increased

V. Findings: Fungal Meningitis

  1. CSF Color: Clear to Cloudy Fluid
  2. CSF Glucose < 50
  3. CSF Protein > 45
  4. CSF Leukocytes: Monocytes increased
  5. CSF Opening Pressure: Increased

VI. Findings: TuberculosisMeningitis

  1. CSF Color: Cloudy Fluid
  2. CSF Glucose < 50
  3. CSF Protein > 45
  4. CSF Leukocytes
    1. Early: Neutrophils increased
    2. Later: Lymphocytes increased

VII. Findings: Intracranial Hemorrhage

  1. CSF Color: Bloody CSF with Xanthochromia
  2. CSF Glucose: Normal or decreased
  3. CSF Protein: >45
  4. CSF Red Blood Cells: Increased
  5. CSF Opening Pressure: Increased >200

VIII. Findings: Neoplasm

  1. CSF Color: Clear or xanthochromic
  2. CSF Glucose: Normal or decreased
  3. CSF Protein: Normal or increased
  4. CSF Leukocytes: Normal or increased Lymphocytes
  5. CSF Opening Pressure: Increased >200

IX. Findings: Neuro-Syphilis

  1. CSF Color: Clear to cloudy fluid
  2. CSF Glucose: Normal
  3. CSF Protein: >45
  4. CSF Leukocytes: Monocytes increased
  5. CSF Opening Pressure: Normal or increased

X. Findings: Guillain-Barre

  1. CSF Color: Clear to cloudy fluid
  2. CSF Glucose: Normal
  3. CSF Protein much greater than 45
  4. CSF Leukocytes: Lymphocytes normal or increased
  5. CSF Opening Pressure: Normal

XI. References

  1. Kooiker in Roberts (1998) Procedures in ER, p. 1067-75
  2. Ravel (1995) Lab Medicine, Mosby, p. 294-9
  3. Tunkel in Mandell (2000) Infectious Disease, p. 974-8
  4. Griffith (1994) Neurol Clin 12:541-64 [PubMed]
  5. Mount (2017) Am Fam Physician 96(5): 314-22 [PubMed]
  6. Seehusen (2003) Am Fam Physician 68:1103-8 [PubMed]

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Ontology: Nonspecific abnormal findings in cerebrospinal fluid (C0151583)

Concepts Finding (T033)
ICD9 792.0
ICD10 R83 , R83.9
SnomedCT 207335007, 158579002
English Nonspecific abnormal findings in cerebrospinal fluid, CSF ABNORMAL, Abnormal findings in cerebrospinal fluid, unspecified abnormal finding, Cerebrospinal fluid abnorm., Cerebrospinal fluid abnormality, [D]Cerebrospinal fluid abnormality (context-dependent category), [D]Cerebrospinal fluid abnorm., [D]Cerebrospinal fluid abnormality, Spinal fluid abnorm, Cerebrospinal fluid abnormal, CSF abnormal, CSF abnormal NOS, CSF abnormality NOS, Abn fnd-cerebrospinal fl, Abnormal findings in cerebrospinal fluid, abnormalities csf, cerebrospinal fluid abnormality, abnormal csf, [D]Cerebrospinal fluid abnormality (situation), cerebrospinal; abnormal fluid, cerebrospinal; fluid abnormal, fluid; abnormal, cerebrospinal, abnormal; fluid, cerebrospinal, abnormality; fluid, cerebrospinal, Cerebrospinal fluid abnormal NOS, Cerebrospinal fluid abnormality NOS
Dutch CSV abnormaal, niet-specifieke abnormale bevindingen in cerebrospinaal vocht, CSV abnormaliteit NAO, cerebrospinaal vocht abnormaal, cerebrospinaal vocht abnormaal NAO, ruggenmerg vocht abnormaal, abnormaal; vloeistof, cerebrospinaal, afwijking; vloeistof, cerebrospinaal, cerebrospinaal; afwijking vloeistof, cerebrospinaal; vloeistof afwijkend, vloeistof; afwijkend, cerebrospinaal, Afwijkende bevindingen in cerebrospinale vloeistof; Niet gespecificeerde afwijkende bevinding, Afwijkende bevindingen in cerebrospinale vloeistof
French LCR anormal SAI, Résultats anormaux non spécifiques de l'examen du liquide céphalo-rachidien, Anomalie du LCR SAI, Liquide céphalo-rachidien anormal, LCR anormal, Liquide rachidien anormal, ANOMALIE DU LCR
German Liquoranomalie NNB, unspezifische anomale Befunde im Liquor, Liquor anomal, Liquor anomal NNB, Abnorme Liquorbefunde: Nicht naeher bezeichneter abnormer Befund, Abnorme Liquorbefunde, LIQUOR PATHOLOGISCH VERAENDERT
Italian Liquido cerebrospinale anormale non specificato, Liquido cerebrospinale anormale, Alterazione del liquido cerebrospinale NAS, Reperti anormali non specifici nel liquido cerebrospinale, Liquido spinale anormale
Portuguese LCR anormal, LCR anormal NE, Anomalia do LSR NE, Líquido cefalorraquidiano anormal, Dados anormais inespecíficos do LCR, ALTERACOES DO LIQUOR
Spanish Líquido cefalorraquídeo anormal, LCR anormal, LCR anormal NEOM, Anormalidad del LCR NEOM, Hallazgos anormales no específicos en el líquido cefalorraquídeo, [D]anomalía del líquido cefalorraquídeo (categoría dependiente del contexto), Líquido raquídeo anormal, LCR ALTERADO, [D]anomalía del líquido cefalorraquídeo (situación), [D]anomalía del líquido cefalorraquídeo
Japanese 髄液異常, 髄液の非特異的異常所見, ＣＳＦ異常ＮＯＳ, ＣＳＦ異常, ｽﾞｲｴｷﾉﾋﾄｸｲﾃｷｲｼﾞｮｳｼｮｹﾝ, 脊髄液異常, CSFｲｼﾞｮｳNOS, CSFｲｼﾞｮｳ, ｽﾞｲｴｷｲｼﾞｮｳ, ｾｷｽﾞｲｴｷｲｼﾞｮｳ
Czech Nespecifické abnormální nálezy v mozkomíšním moku, Mozkomíšní mok abnormální, Abnormalita CSF NOS, Abnormální míšní mok, CSF abnormální, CSF abnormální NOS
Korean 뇌척수액의 이상 소견
Hungarian Liquor kóros, Liquor kóros k.m.n., Gerincfolyadék kóros, Liquor-rendellenesség k.m.n., Nem specifikus kóros liquor leletek
Derived from the NIH UMLS (Unified Medical Language System)

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