Cerebrospinal fluid

The subarachnoid space on the outside of the brain is in continuity with a similar space around the spinal cord and also with the series of interconnected cerebral ventricles within the brain, the choroid plexus secretes CSFcerebral ventricles

Circulation: After its formation in the ventricles, CSF exist from the ventricles through the foramina and circulates over the both hemispheres of the brain, downward over the spinal cord, and to the nerve roots. Circulation of the CSF occurs slowly, allowing the time needed for long contact with cells in the CNS. In the dural sinuses, CSF is reabsorbed by the arachnoid villi.

Composition and appearance: CSF is normally a clear, amazingly ‘bright’ fluid, and if it is cloudy or contains a raised level of protein or traces of blood this is usually an indication of brain infection, some types of brain or spinal cord tumor, or trauma. The protein content is about 100 times less than that of plasma (0.5 g/liter compared to g/liter).

CSF is a weak salt solution with similar inorganic ion concentrations to plasma (but with small and significant differences The protein content is about 100 times less than that of plasma (0.5 g/liter compared to g/liter).

Function: ● Serve as a protective fluid cushioning and lubricating the brain and spinal column. This cushions and helps prevent injury to the brain. ● Serve as a nutrient and metabolic waste exchange fluid.

Diagnosis and therapy: Abnormalities of the CSF can be important in diagnosis of some medical conditions; the fluid can be sampled by lumbar puncture from the extension of the subarachnoid space (the lumbar sac) below the lower end of the spinal cord. usually between the third and fourth lumbar vertebrae

Lumber Puncture Needles

Normal results in adults Appearance: Clear WBC count: 0-5 cells/µL (< 2 Glucose level: >60% of serum glucose Protein level: < 45 mg/dL

Bacterial meningitis Appearance:Cloudy Opening pressure: Elevated (>25 cm H 2 O) WBC count: >100 cells/µL (>90% PMN); Glucose level: Low (< 40% of serum glucose) Protein level: Elevated (>50 mg/dL)

Multiple sclerosis MS A disease in which the body’s immune system eats away at the protective sheeth ( Myelin) which causes deterioration of nerves which is irreversible CSF of patients with MS contains elevated levels of IgG and a protein called oligoclonal band which result due to the break down of myelin

Multiple sclerosis Appearance: Clear Opening pressure: Normal WBC count: 0-20 cells/µL (lymph) Glucose level: Normal Protein level: Elevated

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