Cerebrospinal Fluid

CSF Formation
 CSF between pia and arachnoid
maters
 subarachnoid space.
 CSF produced by ventricular
capillary blood vessels
 choroid plexuses
 CSF Volumes and Function
 Total CSF volumes:
 Adult 85 - 150 ml
 Neonate 10 - 60 ml
 Adult Rate of Formation 500 ml/day
 Turn over = 20 mL/hour
 PHYSIOLOGY
1. To supply nutrients to the nervous system
2. To remove metabolic wastes
3. To produce a mechanical barrier to cushion the brain
and spinal cord against trauma.
CSF Collection Indications
Meningeal
infection

Subarachnoi
Fever of
d
hemorrhage
Unknown Malignancy

Origin

Neurological
disease
 CSF

 Cells counting:
 Viscosity Macroscopic  Total cellular count
WBCs and differential
 Turbidity (Gross) 

 color Examination Microscopic  RBCs count

 Serological tests:
Examination  Protein
 Sugar
 Cultures and Gram stain
Differentials

 Performed on a stained*
smear made from CSF.
 It is recommended that
stained smears be made
even when the total cell
count is within normal
limits.

*usually Wright’s stain

Normal CSF Differential Cell Count
Prominent Cells in CSF and Clinical Significance
Cells Observed in CSF

PMNs,
Lymphocytes
Monocyte
Lymphocytes
 Phagocytized RBCs by
macrophages
 Hematoidin Bodies in
macrophages
 Graphic accessed URL http://www.geocities.com/jcprolla/481a.jpg, 2009.

Cells Observed in CSF

Anthrax in CSF. Many reactive lymphocytes and macrophages.

Large lymphoid cells with dispersed chromatin, prominent
nucleoli, and scant cytoplasm in the CSF; observed in the one
case of typical MCL
CSF cytology. A. Nests of anaplastic tumor cells are seen with round to oval
eccentric nuclei, coarse chromatin, prominent nucleoli and moderate
homogeneous cytoplasm . B. Single giant malignant cells.