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CSF analysis

Cerebrospinal fluid analysis

Cerebrospinal fluid (CSF) analysis is a group of laboratory tests that measure chemicals in the cerebrospinal fluid. CSF is a clear fluid that surrounds and protects the brain and spinal cord. The tests may look for proteins, sugar (glucose), and other substances.

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Lumbar puncture (spinal tap)
CSF chemistry

How the Test is Performed

A sample of CSF is needed. A lumbar puncture, also called a spinal tap, is the most common way to collect this sample. Less common ways to take a fluid sample include:

After the sample is taken, it is sent to the laboratory for evaluation.

Your health care provider will ask you to lie flat for at least one hour after the lumbar puncture. You may develop a headache after the lumbar puncture. If it happens, fluids and drinking caffeinated beverages such as coffee, tea or soda may help.

How to Prepare for the Test

Your provider will tell you how to prepare for lumbar puncture. Make sure to let them know all of the medicines you are taking in case any adjustment is needed.

Why the Test is Performed

Analysis of CSF can help detect certain conditions and diseases. All of the following can be, but are not always, measured in a sample of CSF:

Normal Results

Normal results include:

Normal value ranges may vary slightly among different laboratories. Talk to your provider about the meaning of your specific test results.

The examples above show the common measurements for results for these tests. Some laboratories use different measurements or may test different specimens.

What Abnormal Results Mean

An abnormal CSF analysis result may be due to many different causes, including:

Related Information

CSF cell count
Cerebrospinal fluid (CSF) culture
CSF total protein
CSF glucose test
CSF-VDRL test
CSF coccidioides complement fixation test
CSF oligoclonal banding
Lactate dehydrogenase test
Cytologic evaluation
Loss of brain function - liver disease
Reye syndrome
Meningitis

References

Euerle BD. Spinal puncture and cerebrospinal fluid examination. In: Roberts JR, Custalow CB, Thomsen TW, eds. Roberts and Hedges' Clinical Procedures in Emergency Medicine and Acute Care. 7th ed. Philadelphia, PA: Elsevier; 2019:chap 60.

Rosenberg GA. Brain edema and disorders of cerebrospinal fluid circulation. In: Jankovic J, Mazziotta JC, Pomeroy SL, Newman NJ, eds. Bradley and Daroff's Neurology in Clinical Practice. 8th ed. Philadelphia, PA: Elsevier; 2022: chap 88.

Schnapp BH, Jewell C. Central nervous system infections. In: Walls RM, ed. Rosen's Emergency Medicine: Concepts and Clinical Practice. 10th ed. Philadelphia, PA: Elsevier; 2023:chap 95.

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Review Date: 4/29/2023  

Reviewed By: Joseph V. Campellone, MD, Department of Neurology, Cooper Medical School of Rowan University, Camden, NJ. Review provided by VeriMed Healthcare Network. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.

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