CerebrospinalFluid(CSF)ExaminationOutlineCSF:colourlessliquidthatflowsthroughthefourcerebralventricles,subarachnoidspaceandspinalcanalsurroundingthebrainandspinalcord.CSFcirlulationcommunicatewithbloodcirculationAdult:90—150mlNewborn:10—60mlbloodbrainbarrierAIMS中枢神经感染性疾病的诊断与鉴别诊断。脑血管疾病的诊断与鉴别诊断。协助脑部肿瘤的诊断。中枢神经系统疾病的治疗与疗效观察。ContentsofexaminationGeneralProperties:pressure、color、Transparency、ClotsandfilmChemicalExamination:protein、glucose、chlorideMicroscopyBacteriologicalExaminationPressure•GeneralProperties•Adult(lying):80—180mmH2O,40-50drips/minchildren:40-100mmH2O。Increase:Intracranial•Inflammation:meningitis,cephalitis,myelitis•cerebraledema,cerebralhemorrhage,braintumorsExtracranial:hypertension,congestiveheartfailureDecrease:CSFcirculationobstruction,lossorimpairmentinsecretionColorchangesColorofCSFConditionsorcausesClear,colorlessnormalMilkyWithWBCincreasePinktoyellowWithbloodYellowHyperbilirubinemiaProtein≥1.5g/LGreenPurulentCSFBrowntoBlackMeningealmelanomaTransparencyNormal:Clear,colorlessClearorCloudy:ViralMeningitis、EpidemicEncephalitisBorSyphilisinCNSGroundglassopacity:TuberculousMeningitisMilkyturbid:PurulentMeningitisClotsandfilmNormal:Noclotsorfilmin24hoursPurulentMeningitis:clotsobservedin1-2hoursTuberculousMeningitis:thinfilmcoverafter12—24hoursSubarachnoidobstruction:yellowjellyProteinQualitative:Pandytest:-/±Quantitative:0.15~0.45g/L(adult,lumbarpuncture)++++++++++ChemicalexaminationClinicalsignificanceinflammation:PM:↑↑↑TM:↑↑VM:↑Hemorrhageincranialorsubarachnoidintracranialmasslesions:tumor,hematomamultiplesclerosis,neurosyphilisGlucoseinCSFNormalvalue:Adult:2.5—4.5mmol/LChild:3.1—4.5mmol/LGCSF/GP:0.3—0.9ClinicalsignificanceInflammation:PM:↓↓↓TM:↓VM:normalIntracranialtumor,neurosyphilisHypoglycemiaChlorideinCSFAdult:120—130mmol/LTM:↓↓↓,<102mmol/LPM:102—116mmol/L。Hypochloremia,suchasseverevomit、diarrhea,dehydrationNormalValueRBC:noneWBC:adult:0—8×106/Lchild:0—15×106/LMicroscopicExaminationClinicalSignificanceInfectiousDiseasesinCNSPURULENTMENINGITIS1000-2000×106/L,segmentedneutrocyteTuberculousMeningitis<500×106/L,segmentneutrocytesinearlystage,andlymphocytesincreaseafterward,plasmocytealsoobservedViralMeningitis<1000×106/L,lymphocytesClinicalSignificanceBraintumor:lymphocytesandtumorcellsParasiticencephalopathy:eosinophilegranulocyteHemorrhage:RBCNORMALPMTMVMSAHPressuremmH2O70-180↑↑↑或↑↑↑↑AppearanceClear,colorlessMilky、greenGroundGlassopacityclearbloodyClotsandfilmnoclotsThinfilmNojellyprotein0.2-0.4g↑↑↑↑↑↑Glucosemmol/L2.5-4.5↓↓Normal↓Chloridemmol/L119-129↓↓↓NormalNormalCellsNoneutrocytesNeutrocytes,lymphocytesandplasmacellslymphocytesRBCBACTERIALSNOpyogenictuberclebacillusNonoGeneralconceptsserousmembranefluid:pleuraleffussionperitoneumserouspericardialeffusionSerousMembraneFluidClassificationTransudate:non-inflammatoryExudate:inflammatorydifferentialdiagnosisoftransudateorexudateTransudateExudatecausesIncreasedcapillarypermeabilityInfection,malignantcancerAppearanceLightyellow,clearorcloudyBloody,purulent,milkyturbidgravity<1.018>1.018clotting-+Cells<100×106/L,lymphocytes>100×106/L,differentcellsbacteriology-+Totalprotein<25g/L>30g/LRivalta-+Glucose>3.3mmol/L<3.3mmol/LPleuralfluid/serumTP<0.5>0.5Pleuralfluid/serumLDH<0.6>0.6LDH<200IU>200IU