Chemical Analysis

Marc Punongbayan 3CMT

Chemical Analysis

Protein Glucose Lactose

Protein

Normal Value: 15-45 mg/dL Contains protein fractions similar to those found in the serum

Albumin is the most abundant protein present

Protein

Methods

Dye-binding Turbidimetric method (nephelometry) Immunochemistry Modified biuret

Protein

Normal CSF/serum albumin ratio 1 : 236 Normal CSF/serum albumin index <9

9-14 index: slight impairment

15-30 index: moderate impairment

>30: severe impairment Excess of 100 index: complete breakdown of the blood-brain barrier

Protein

Increased (Hot Time)

Neonates and 40yrs above Hemorrhage Obstruction Traumatic tap Toxic condition Infections Multiple sclerosis Endocrine disorders

Protein

Decreased

Fluid loss from dural tear Sudden loss of CSF volume during pneumoencephalography Increased absorption by arachnoid vili Increased cranial pressure Blood-brain barrier damage Hyperthyroidism

Glucose

Normal Value: 60-70% of plasma (50-80 mg/dL) Actively transported by endothelial cells Moves across concentrated gradient by diffusion

Glucose

Increased

Hyperglycemia (increased plasma glucose) Traumatic tap Diabetic coma

Glucose

Decreased

CNS infections (leukocytes and microorganisms consumption of glucose) Hypoglycemia Impaired glucose transport Increased CNS glycolytic activity Insulin shock Metastatic carcinoma

Lactate

Normal Value: 11-22 mg/dL Independent from plasma lactate level Present due to CNS anaerobic metabolism Aid in the diagnosis of meningitis

Lactate

Bacterial Meningitis

>35mg/dL

Viral Meningitis

<25mg/dL

Lactate

Increased (Oxygen deprivation)

Hypoxia Cerebral infarct (Ischemic Stroke) Trauma to the brain Arteriosclerosis (Artery stiffening) Intracranial hemorrhage Cerebral edema (accumulation of water in the cranial cavities)

Hypotension
Meningitis Hydrocephalus