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.
Cerebrospinal fluid analysis
How the Test is Performed
A sample of CSF is needed. A
- Removal of CSF from a tube that is already in the CSF, such as a shunt, ventricular drain, or pain pump
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
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:
- Antibodies and DNA of common viruses
- Bacteria (including that which causes syphilis, using a
VDRL test) Cell count
Lactate dehydrogenase Oligoclonal bandingto look for specific proteins
- Myelin basic protein
- Whether there are cancerous cells present (CSF cytology)
- Opening pressure
Normal results include:
- Antibodies and DNA of common viruses: None
- Bacteria: No bacteria grows in a lab culture
- Cancerous cells: No cancerous cells present
- Cell count: 0 to 5 white blood cells (all mononuclear) and 0 red blood cells
- Chloride: 110 to 125 mEq/L (110 to 125 mmol/L)
- Fungus: None
- Gamma globulin: 3% to 12% of the total protein
- Glucose: 50 to 80 mg/dL or 2.77 to 4.44 mmol/L (or greater than two-thirds of blood sugar level)
- Glutamine: 6 to 15 mg/dL (410.5 to 1,026 micromol/L)
- Lactate dehydrogenase: less than 40 U/L
- Oligoclonal bands: 0 or 1 bands that are not present in a matched serum sample
Protein: 15 to 60 mg/dL (0.15 to 0.6 g/L)
- Opening pressure: 70 to 180 mm of water
- Myelin basic protein: Less than 4ng/mL
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:
Encephalitis(such as Herpes simplex, West Nile, and Eastern Equine Encephalitis virus) Hepatic encephalopathy
- High blood sugar (hyperglycemia)
Reye syndrome Meningitisdue to bacteria, fungus, tuberculosis, or a virus
- Multiple sclerosis (MS)
- Alzheimer disease
- Pseudotumor cerebrii
- Normal pressure hydrocephalus
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.
Review Date: 29/04/2023
The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed physician should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. Copyright ©2019 A.D.A.M., Inc., as modified by University of California San Francisco. Any duplication or distribution of the information contained herein is strictly prohibited.
Information developed by A.D.A.M., Inc. regarding tests and test results may not directly correspond with information provided by UCSF Health. Please discuss with your doctor any questions or concerns you may have.