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Alternative namesChemistry - CSF
This test is an analysis of cerebral spinal fluid (CSF). CSF bathes, cushions, and protects the brain and spinal cord. It flows around the skull and spine in the subarachnoid space (the area immediately surrounding the brain and spinal cord).
CSF chemistry test identifies chemicals such as proteins and glucose levels, which can help diagnose certain disorders and diseases.
How the test is performed
A lumbar puncture ( spinal tap ) is the most common means of CSF collection. Generally, this is performed as follows: You are positioned on your side with your knees curled up to your abdomen and your chin tucked in to your chest. Local anesthetic is injected over the lower spine. The spinal needle is inserted, usually between the 3rd and 4th lumbar vertebrae, and fluid is withdrawn for testing. You will be asked to remain flat, or nearly flat, for 6 to 8 hours after the test.
Alternative methods of obtaining CSF are rarely used, but they may be recommended if you have a problem such as lumbar deformity or infection, which would make lumbar puncture impossible or unreliable:
The CSF is then sent to the laboratory for evaluation.
How to prepare for the test
Be prepared to sign a consent form and to remain in the hospital for at least 6 to 8 hours after the test.
Infants and children:
How the test will feel
The curled position may be uncomfortable but is necessary to avoid moving the needle and possibly injuring the spinal cord.
The anesthetic will sting or burn when first injected. There will be a hard pressure sensation when the needle is inserted, and there is usually some brief pain when the needle goes through the meninges. (See CSF collection .)
Overall, discomfort is minimal to moderate. The entire procedure usually takes about 30 minutes. The actual fluid collection only takes a few minutes.
Why the test is performedThis test is performed to evaluate the following:
What abnormal results mean
Abnormal glutamine results may indicate hepatic encephalopathy or Reye's syndrome . Elevated lactate dehydrogenase levels may indicate inflammation or infection. Decreased glucose may suggest meningitis due to bacteria, fungus, or tuberculosis. Increased white blood cells may indicate an infection or another inflammatory process.
For more information on abnormal values, please see the specific test.
What the risks are
Risks of lumbar puncture include:
Cisternal puncture or ventricular puncture carries additional risk of damage to the brainstem or brain tissue and risk of bleeding within the brain, potentially resulting in incapacitation or death.
Update Date: 1/12/2003Elaine T. Kiriakopoulos, M.D., M.Sc., Department of Neurology, Beth Israel Deaconess Medical Center, Harvard University, Boston, MA. Review provided by VeriMed Healthcare Network.
Last updated: Tue, 06 Jan 2009 00:20:03 GMT