Indian Journal of Critical Care Medicine

Register      Login

SEARCH WITHIN CONTENT

FIND ARTICLE

Volume / Issue

Online First

Archive
Related articles

VOLUME 23 , ISSUE S2 ( June (Supplement-2), 2019 ) > List of Articles

NEUROCRITICAL CARE

Cerebrospinal Fluid (CSF) Analysis and Interpretation in Neurocritical Care for Acute Neurological Conditions

Ajay Prasad Hrishi, Manikandan Sethuraman

Keywords : Acute neurological condition, Cerebrospinal fluid analysis, Demyelination: trauma, Meningitis, SAH

Citation Information : Hrishi AP, Sethuraman M. Cerebrospinal Fluid (CSF) Analysis and Interpretation in Neurocritical Care for Acute Neurological Conditions. Indian J Crit Care Med 2019; 23 (S2):115-119.

DOI: 10.5005/jp-journals-10071-23187

License: CC BY-NC 4.0

Published Online: 01-06-2019

Copyright Statement:  Copyright © 2019; Jaypee Brothers Medical Publishers (P) Ltd.


Abstract

Cerebrospinal fluid (CSF) is a clear fluid circulating in the intracranial and spinal compartments. Under normal conditions, the composition of CSF remains constant. However, in various neurological disease especially in acute conditions, the composition, quantity and its pressure can be altered. By measuring the levels of various CSF components using relevant techniques, diagnosis, severity and prognostication of neurological conditions like infections, subarachnoid hemorrhage, demyelinating conditions, tumor like conditions, etc. can be done. In this review, alterations in CSF components and its relevance to the emergency care physician to help in the management of patients are enumerated.


PDF Share
  1. Seehusen DA, Reeves MM, Fomin DA. Cerebrospinal fluid analysis. Am Fam Physician. 2003 15;68:1103–1108.
  2. Hepnar D, Adam P, Žáková H, Krušina M, Kalvach P, Kasík J, et al. Recommendations for cerebrospinal fluid analysis. Folia Microbiol (Praha).2019;64:443–452.
  3. Costerus JM, Brouwer MC, van de Beek D. Technological advances and changing indications for lumbar puncture in neurological disorders. Lancet Neurol. 2018;17:268–278.
  4. Horlocker TT, Wedel DJ, Rowlingson JC, Enneking FK, Kopp SL, Benzon HT, et al. Regional anesthesia in the patient receiving antithrombotic or thrombolytic therapy: American Society of Regional Anesthesia and Pain Medicine Evidence-Based Guidelines (Third Edition). Reg Anesth Pain Med. 2010;35:64–101.
  5. Perry JJ, Stiell IG, Sivilotti ML, Bullard MJ, Lee JS, Eisenhauer M, et al. High risk clinicalcharacteristics for subarachnoid haemorrhage in patients with acute headache:prospective cohort study. BMJ. 2010 28;341:c5204.
  6. Vivancos J, Gilo F, Frutos R, Maestre J, García-Pastor A, Quintana F, et al. Guía de actuación clínica en la hemorragia subaracnoidea. Sistemática diagnóstica y tratamiento. Neurología. 2014;29:353–370.
  7. Carpenter CR, Hussain AM, Ward MJ, Zipfel GJ, Fowler S, Pines JM, et al. Spontaneous Subarachnoid Hemorrhage: A Systematic Review and Meta-analysis Describing the Diagnostic Accuracy of History, Physical Examination, Imaging, and Lumbar Puncture With an Exploration of Test Thresholds. Acad Emerg Med. 2016;23:963–1003.
  8. M Vermeulen, J van Gijn. The diagnosis of subarachnoid haemorrhage. J Neurol Neurosurg and Psychiatry. 1990;53: 365–372.
  9. Griffiths MJ, McGill F, Solomon T. Management of acute meningitis. Clin Med(Lond). 2018 ;18:164–169.
  10. Tunkel AR, Hasbun R, Bhimraj A, Byers K, Kaplan SL, Michael Scheld W, et al. 2017 Infectious Diseases Society of America's Clinical Practice Guidelines for Healthcare-Associated Ventriculitis and Meningitis. Clin Infect Dis. 2017; 64:e34-e65.
  11. Kumar R. Aseptic Meningitis: Diagnosis and Management. Indian J Pediatr 2005;72:57–63.
  12. Freedman MS, Thompson EJ, Deisenhammer F, Giovannoni G, Grimsley G, Keir G, et al. Recommended standard of cerebrospinal fluid analysis in the diagnosis of multiple sclerosis: a consensus statement. Arch Neurol. 2005 ;62:865–870.
  13. Matas SL, Glehn Fv, Fernandes GB, Soares CA. Cerebrospinal fluid analysis in the context of CNS demyelinating diseases. Arq Neuropsiquiatr. 2013;71:685–688.
  14. Willison HJ, Jacobs BC, van Doorn PA. Guillain-Barré syndrome. Lancet. 2016;388:717–727.
  15. Rodríguez Y, Rojas M, Pacheco Y, Acosta-Ampudia Y, Ramírez-Santana C, Monsalve DM, et al. Guillain-Barré syndrome, transverse myelitis and infectious diseases. Cell Mol Immunol. 2018;15:547–562.
  16. Ballester LY, Lu G, Zorofchian S, Vantaku V, Putluri V, Yan Y, et al. Analysis of cerebrospinal fluid metabolites in patients with primary or metastatic centralnervous system tumors. Acta Neuropathol Commun. 2018;6:85.
  17. Axelsson M, Sjögren M, Andersen O, Blennow K, Zetterberg H, Lycke J. Neurofilament light protein levels in cerebrospinal fluid predict long-term disability of Guillain-Barré syndrome: A pilot study. Acta Neurol Scand. 2018;138:143–150.
  18. Claudia R, Carlotta Marzocchi, S Stefania B. Micro RNAs as Biomarkers in Amyotrophic lateral sclerosis. Cells 2018;7:219.
  19. Pan W, Gu W, Nagpal S, Gephart MH, Quake SR. Brain tumor mutations detected in cerebral spinal fluid. Clin Chem. 2015 ;61:514–522.
  20. Fortuna D, Hooper DC, Roberts AL, Harshyne LA, Nagurney M, Curtis MT. Potential role of CSF cytokine profiles in discriminating infectious from non-infectious CNS disorders. PLoS ONE 2018; 13: e0205501.
  21. Seth T, Rihab G, Casey PS, Femke S, Sunita S, Stephanie F, et al. Micro RNA biomarkers in cerebrospinal fluid and serum reflect injury severity in human acute traumatic spinal cord injury. J Neurotrauma.
  22. doi: 10.1089/neu.2018. 6256.
  23. Kwon BK, Streijger F, Fallah N, Noonan VK, Bélanger LM, Ritchie L, et al. Cerebrospinal fluid biomarkers to stratify injury severity and predict outcome in human traumatic spinal cord injury. J Neurotr. 2017;34:567–580.
  24. Yokobori S, Zhang Z, Moghieb A, Mondello S, Gajavelli S, Dietrich WD, et al. Acute diagnostic biomarkers for spinal cord injury: review of the literature and preliminary research report. World Neurosurg. 2015; 83:867–878.
PDF Share
PDF Share

© Jaypee Brothers Medical Publishers (P) LTD.