The rates of cerebrospinal fluid in diseases

  • The rates of cerebrospinal fluid in diseases

    Xanthochromic coloring( yellow, yellow-gray, yellow-brown, green) appears with jaundice;tumors of the brain, rich in blood vessels and close to the cerebrospinal fluid;cysts;subarachnoidal administration of large doses of penicillin;in newborns this color is physiological in nature.

    Red color( erythrochromia) gives the CSF unchanged blood, which can appear as a result of trauma, hemorrhage.

    Dark-cherry or dark-brown color is possible with hematomas and liquor fluid from cysts.

    Turbidity of CSF is possible with purulent meningitis, breakthrough of abscess into subarachnoid space, poliomyelitis, tuberculosis and serous meningitis( the appearance of turbidity immediately or after standing of the liquid during the day).Inflammatory processes of the meninges shift the pH to the acid side.

    An increase in protein in cerebrospinal fluid can occur with tuberculous, purulent, serous meningitis, hemodynamic disorders, after brain operations,

    with brain tumors, poliomyelitis, brain trauma with subarachnoid hemorrhage, nephritis with uremia. In acute inflammation, a-globulins increase, in the case of chronic inflammations, b- and y-globulins.

    Positive reactions of Pandi and Nonne Apelt indicate an increased content of the globulin fraction and accompany cerebral hemorrhages, brain tumors, meningitis of various origins, progressive paralysis, dorsal and multiple sclerosis. Admixture to the blood liquor always gives positive globulin reactions.

    The concentration of glucose in cerebrospinal fluid for various diseases is shown in the table.

    Table Changes in glucose content in cerebrospinal fluid for various diseases

    Table Changes in glucose content in cerebrospinal fluid for various diseases

    The concentration of chlorides in CSF for various diseases is shown in Table. .

    Table Change in contentChlorides in CSF for various diseases

    Table Change in chloride content in CSF in various diseases

    Pleocytosis - an increase in the number of cellsin the liquor. Minor pleocytosis is possible with progressive paralysis, syphilis, specific meningitis, arachnoiditis, encephalitis, multiple sclerosis, epilepsy, tumors, trauma to the spine and brain. A massive pleo-cytosis is observed in acute purulent meningitis, an abscess. Despite the fact that the results of the CSF study for different types of meningitis may be the same, the most common data are given in Table. .

    Lymphocytic pleocytosis is observed in the postoperative period with neurosurgical operations, chronic inflammation of the brain membranes( tuberculous meningitis, cysticercosis arachnoiditis), viral, syphilitic, fungal meningoencephalitis. Moderate pleocytosis with

    by the predominance of lymphocytes is possible when the pathological process is localized in the depth of the brain tissue. Unchanged neutrophils are observed when fresh blood enters the cerebrospinal fluid during operations on the brain, with acute inflammation;altered neutrophils - with the attenuation of the inflammatory process. The combination of unchanged and altered neutrophils indicates an exacerbation of inflammation. A sharp appearance of a large neutrophilic pleocytosis is possible when an abscess breaks into liquor spaces. At a poliomyelitis in the beginning of disease the neutrophils prevail, and then lymphocytes.

    Table Changes in cerebrovascular, bacterial, viral, fungal and tubercular meningitis

    Table Changes in CSF values ​​characteristic of bacterial, viral, fungal and tubercular meningitis

    Eosinophils are detected in subarachnoid hemorrhages, toxic, reactive, tubercular, syphilitic, epidemic meningitis,tumors, cysticercosis of the brain.

    Plasma cells are found in encephalitis, tuberculous meningitis, sluggish wound healing after surgery.

    Macrophages are detected in normal cytosis after bleeding and in the inflammatory process. A large number of macrophages in the liquor can be detected during its sanation in the postoperative period. The absence of them in pleocytosis is a poor prognostic sign. Macrophages with droplets of fat in the cytoplasm( granular spheres) are present in the fluid from the brain cysts and with certain tumors( craniopharyngioma, ependymoma).

    Epithelial cells are defined in neoplasms of the membranes, sometimes in the inflammatory process.

    Cells of malignant tumors can be found in the cerebrospinal fluid of the brain with metastases of cancer and melanoma in the cerebral cortex, subcortical areas, cerebellum;Blast cells - with neuroleukemia.

    Erythrocytes appear in cerebrospinal fluid with intracranial hemorrhages( in this case, not so much their absolute number as the increase in the re-examination value is important).