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CSF Analysis

Also known as: Spinal fluid analysis
Formal name: Cerebrospinal fluid analysis
Related tests: Glucose, Total Protein, CBC (Complete Blood Count), Lactate, Protein Electrophoresis, Antibody Tests, AFB Smear and Culture, Blood Culture, Herpes, Lyme Disease, Rubella, Syphilis, West Nile Virus

The Test

How is it used?

Cerebrospinal fluid (CSF) analysis may be used to help diagnose a wide variety of diseases and conditions affecting the central nervous system (CNS). They may be divided into four main categories:
  • Infectious diseases such as meningitis and encephalitis—testing is used to determine if the cause is bacterial, tuberculous, fungal or viral, and to distinguish it from other conditions; may also be used to detect infections of or near the spinal cord or to investigate a fever of unknown origin.
  • Bleeding (hemorrhaging) within the brain or skull
  • Diseases that cause inflammation or other immune responses such as antibodies—these may include autoimmune disorders such as Guillain-Barré syndrome or sarcoidosis or diseases that cause the destruction of myelin such as multiple sclerosis
  • Tumors located within the CNS (primary) or metastatic cancer

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    When is it ordered?

    CSF analysis may be ordered when a doctor suspects that a patient has a condition or disease involving their CNS. A patient’s medical history may prompt the request for CSF analysis. It may be ordered when a patient has suffered trauma to the brain or spinal cord, has been diagnosed with cancer that may have spread (metastatic) or has signs or symptoms suggestive of a condition involving their CNS.

    The signs and symptoms of CNS conditions can vary widely and many overlap with a variety of diseases and disorders. They may have sudden onset, suggesting an acute condition such as CNS bleeding or infection or may be slow to develop, indicating a chronic disease such as cancer or multiple sclerosis.

    Depending on a patient’s history, doctors may order CSF analysis when some combination of the following signs and symptoms appear:

    • changes in mental status and consciousness
    • confusion, hallucinations or seizures
    • muscle weakness or lethargy, fatigue
    • nausea
    • flu-like symptoms that intensify over a few hours to a few days
    • fever or rash
    • sudden, severe or persistent headache or a stiff neck
    • sensitivity to light
    • numbness or tremor
    • dizziness
    • difficulties with speech
    • difficulty walking, lack of coordination
    • mood swings, depression
    • infants may be irritable, cry when they are held, have body stiffness, refuse food, and have bulging fontanels (the soft spots on the top of the head)

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    What does the test result mean?

    CSF usually contains a small amount of protein and glucose and may have a few white blood cells (WBCs).

    Any condition that disrupts the normal pressure or flow of CSF or the protective ability of the blood/brain barrier can result in abnormal results of CSF testing. For detailed explanations of what various tests results may mean, see the sections on:

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    Is there anything else I should know?

    Multiple tubes of CSF are often collected during a lumbar puncture to ensure the quality of samples for testing.

    Bacterial and amoebic meningitis are medical emergencies. Your doctor must rapidly distinguish between these conditions, the generally more mild viral meningitis, and other conditions. Because prompt treatment is crucial, your doctor may start you on a broad-spectrum antibiotic before the diagnosis has been definitely determined.

    To help diagnose your illness your doctor may want to know what recent illnesses and vaccinations you may have had, what symptoms you are experiencing, whether you have been in contact with any ill people, and what places you have recently traveled to.

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