Cerebrospinal fluid (CSF) collection

定义

脑脊液(CSF)采集是一种检查大脑和脊髓周围液体的测试.

CSF acts as a cushion, protecting the brain and spine from injury. The fluid is normally clear. It has the same consistency as water. The test is also used to measure pressure in the spinal fluid.

选择的名字

Spinal tap; Ventricular puncture; Lumbar puncture; Cisternal puncture; Cerebrospinal fluid culture

How the Test is Performed

There are different ways to get a sample of CSF. Lumbar puncture (spinal tap) is the most common method.

接受测试:

• 你将侧卧，膝盖向上拉向胸部，下巴向下收. Sometimes the test is done sitting up, but bent forward.
• After the back is cleaned, 卫生保健提供者将注射局部麻药(麻醉剂)到脊柱下部.
• A spinal needle will be inserted.
• An opening pressure is sometimes taken. An abnormal pressure can indicate an infection or other problem.
• Once the needle is in position, and after the CSF pressure is measured, 1至10毫升(mL)的脑脊液样本在4个小瓶中收集.
• 取出针头，清洗伤口，并在针头处缠上绷带. 你可能会被要求在测试后躺一段时间.

在某些情况下，使用特殊的x射线来帮助引导针头进入位置. This is called fluoroscopy.

腰椎穿刺收集积液也可作为其他程序的一部分，如在将染料插入脑脊液后进行x线或CT扫描.

Rarely, other methods of CSF collection may be used.

• 池穿刺使用一根针放在枕骨下方(颅骨后方)。. It can be dangerous because it is so close to the brain stem. It is always done with fluoroscopy or other imaging guidance.
• 脑室穿刺可能被推荐给可能有脑疝的人. It is most often done in the operating room. 在颅骨上钻一个洞，然后将一根针直接插入其中一个脑室.

CSF也可以从已经放置在液体中的管子中收集, such as a shunt or a ventricular drain.

How to Prepare for the Test

你需要在测试前征得医疗团队的同意. 如果你正在服用阿司匹林或其他血液稀释药物，请告诉十大赌博平台排行榜.

手术后，你应该计划休息几个小时，即使你感觉很好. 这是为了防止液体在穿刺处周围泄漏. You will not need to lie flat on your back the entire time. If you develop a headache, it may be helpful to drink caffeinated beverages such as coffee, 茶还是苏打水.

考试的感觉如何

It may be uncomfortable to stay in position for the test. 保持静止很重要，因为运动可能会导致脊髓损伤.

针到位后，你可能会被告知要稍微挺直你的姿势. This is to help measure the CSF pressure.

The anesthetic will sting or burn when first injected. 当针插入时，会有一种坚硬的压迫感. 经常, 当针穿过脊髓周围的组织时，会有短暂的不适. This pain should stop in a few seconds.

In most cases, the procedure takes about 30 minutes. 实际的压力测量和脑脊液收集只需要几分钟.

Why the Test is Performed

这项测试是为了测量脑脊液内的压力，并收集液体样本以供进一步测试.

CSF analysis can be used to diagnose certain neurologic disorders. 这些可能包括感染(如脑膜炎)和脑或脊髓损伤. A spinal tap may also be done to establish the diagnosis of normal pressure hydrocephalus or bleeding into the spinal fluid from an aneurysm.

正常的结果

Normal values typically range as follows:

• Pressure: 70 to 180 mm H₂O
• Appearance: clear, colorless
• 脑脊液总蛋白: 15 ~ 60mg / 100ml (0.15 to 0.6 g/L)
• Gamma globulin: 3% to 12% of the 血清总蛋白
• CSF葡萄糖: 50 to 80 mg/100 mL or 2.77 to 4.44 mmol/L (or greater than two thirds of blood sugar level)
• 脑脊液细胞计数0 ~ 5个白细胞(均为单核细胞)，无红细胞
• Chloride: 110 to 125 mEq/L

不同实验室的正常值范围可能略有不同. 与您的十大赌博平台排行榜谈谈您的具体测试结果的含义.

上面的示例显示了这些测试结果的常用度量. 一些实验室使用不同的测量方法或可能测试不同的样品.

What Abnormal Results Mean

如果脑脊液看起来浑浊, 这可能意味着有感染或白细胞或蛋白质的积累.

如果脑脊液呈血红色，可能是出血或脊髓梗阻的征兆. 如果它是棕色的, 橙色, 或黄色, 这可能是脑脊液蛋白升高或出血(超过3天)的征兆。. 样本中可能有血液来自于脊髓穿刺. This makes it harder to interpret the test results.

脑脊液压力

• Increased CSF pressure may be due to increased intracranial pressure (pressure within the skull).
• 脑脊液压力降低可能是由于脊髓阻滞、脱水或脑脊液渗漏.

脑脊液蛋白

• Increased CSF protein may be due to blood in the CSF, 糖尿病、多神经炎、肿瘤、损伤或任何炎症或感染性疾病.
• 蛋白质减少是脑脊液快速生成或全身性蛋白质丢失的标志.

CSF葡萄糖

• Increased CSF葡萄糖 is a sign of high blood sugar.
• Decreased CSF葡萄糖 may be due to 低血糖症 (low blood sugar), bacterial or fungal infection (such as 脑膜炎), tuberculosis, or certain other types of 脑膜炎.

脑脊液中的血细胞

• 脑脊液中白细胞增多可能是脑膜炎的征兆， 急性 infection, beginning of a long-term (chronic) illness, tumor, 脓肿, or demyelinating disease (such as 多发性硬化症).
• 脑脊液样本中的红细胞可能是脊髓液出血的迹象或创伤性腰椎穿刺的结果.

其他脑脊液结果

• 脑脊液γ球蛋白水平升高可能是由于诸如 多发性硬化症, 神经梅毒, or 格林-巴利综合征.

Additional conditions under which the test may be performed:

• Chronic inflammatory polyneuropathy
• Dementia due to metabolic causes
• 脑炎
• 癫痫
• Febrile seizure (children)
• Generalized tonic-clonic seizure
• 脑积水
• Normal pressure hydrocephalus (NPH)
• 垂体瘤
• 瑞氏综合征

风险

风险 of lumbar puncture include:

• 椎管或脑周围出血(硬膜下血肿).
• Discomfort during the test.
• Headache after the test that can last a few hours or days. It may be helpful to drink caffeinated beverages such as coffee, 茶还是苏打水 to help relieve the headache. If headaches last more than a few days (especially when you sit, stand or walk) you might have a CSF-leak. You should talk to your physician if this occurs.
• Hypersensitivity (allergic) reaction to the anesthetic.
• Infection introduced by the needle going through the skin.

如果对脑内有肿块(如肿瘤或脓肿)的人进行这项检查，可能会发生脑疝。. This can result in brain damage or death. 如果检查或测试显示出脑肿块的迹象，则不进行此检查.

脊髓神经可能会受到损伤，特别是当患者在测试过程中移动时.

池穿刺或脑室穿刺有脑或脊髓损伤和脑出血的额外风险.

注意事项

This test is more dangerous for people with:

• 脑后部压迫脑干的肿瘤
• 血液凝固问题
• Low platelet count (thrombocytopenia)
• Individuals taking blood thinners, 阿斯匹林, 氯吡格雷, or other similar drugs to decrease the formation of blood clots.

参考文献

德卢卡GC，格里格斯RC. Approach to the patient with neurologic disease. In: Goldman L, Schafer AI, eds. Goldman-Cecil医学. 26日艾德. Philadelphia, PA: Elsevier; 2020:chap 368.

Euerle BD. Spinal puncture and cerebrospinal fluid examination. In: Roberts JR, Custalow CB, Thomsen TW, eds. 罗伯茨和赫奇斯的《十大赌博靠谱网络平台》. 7日艾德. Philadelphia, PA: Elsevier; 2019:chap 60.

罗森博格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. 8日艾德. Philadelphia, PA: Elsevier; 2022:chap 88.