1887

Laboratory evaluation of cerebrospinal fluid

image of Laboratory evaluation of cerebrospinal fluid
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Abstract

Cerebrospinal fluid (CSF) collection and laboratory analysis are recommended as part of the investigation of central nervous system (CNS) disease. A definitive daignosis on the basis of CSF laboratory evaluation alone is rare, but the laboratory evaluation of CSF may provide documentation of normal or abnormal findings and help make distinctions among various differential diagnoses. This chapter covers CSF collection, laboratory analysis of CSF, normal and abnormal CSF and CSF findings in selected clinical conditions. Case examples are included.

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Figures

Image of 25.1
25.1 The correct site for collection of CSF from the cisterna magna is shown in the photograph. The drawing shows the important landmarks of the wings of the atlas vertebra (A) and the occipital protuberance (B), and the craniodorsal tip of the dorsal spine of the axis (C). (Reproduced from the )
Image of 25.3
25.3 (a) A standard haemocytometer used for performing cell counts. The haemocytometer is charged with undiluted fluid by gently touching the tip of a capillary tube containing CSF to the end of the coverslip. (b) A disposable C-Chip haemocytometer is loaded by touching the tip of the charged capillary tube to the semicircular groove. (c) Diagrammatic representation of the grid lines seen microscopically. (d) The grid is viewed at X400 magnification with the condenser lowered. Red cells have a doughnut appearance (R); nucleated cells have a textured appearance and are slightly larger (N). (Courtesy of Elizabeth Villiers)
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25.5 A sedimentation chamber constructed from a syringe barrel, filter paper, a slide and sticky tape. (Courtesy of Roger Powell)
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25.6 A small cluster of surface epithelial cells with small round nuclei and abundant pinkish cytoplasm. (Modified Wrights stain; original magnification X1000) (Courtesy of Paola Monti)
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25.7 Myelin-like material seen in CSF obtained by lumbar puncture from a Border Terrier with intervertebral disc disease. (Modified Wrights stain; original magnification X1000) (Courtesy of Elizabeth Villiers)
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25.9 CSF from a dog with granulomatous meningoencephalitis. There is a mixed cell pleocytosis with moderate neutrophils (N) and macropahges (Mφ). A single eosinophil (E) is seen. (Wright–Giemsa stain; original magnification X1000)
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25.10 CSF from a dog with steroid-responsive meningitis–arteritis. There are numerous non-degenerate neutrophils as well as a moderate number of monocytes and a few small lymphocytes. Compare with Figure 25.11 showing degenerate and distorted neutrophils. (Modified Wright’s stain; original magnification X500) (Courtesy of Francesco Cian)
Image of 25.11
25.11 CSF from a dog with bacterial meningoencephalitis and sepsis. There are degenerate, smudged and distorted neutrophils (N) with blue-staining intracellular bacterial cocci. Compare with Figure 25.10 . (Wright–Giemsa stain; original magnification X1000)
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25.12 CSF from a dog with multicentric lymphoma and neurological signs. There are numerous large lymphoid cells with prominent nucleoli. (Wright–Giemsa stain; original magnification X1000)
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25.13 Cytospin preparation of CSF. (Modified Wright’s stain; original magnification X1000)
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25.14 Cytospin preparation of CSF. (Modified Wright–Giemsa stain; original magnification X1000) (Courtesy of Francesco Cian)

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