Cerebrospinal Fluid - A Clinicopathologic Analysis.

Context and Objective: This study aims to emphasize the importance of an appropriate CSF examination in patients of suspected CNS disease and the necessity of correlating it with the clinico-radiologic findings which will help in early diagnosis of CNS diseases and guide the further management of the disease.

Design: In this 2 year study, 215 CSF samples from patients with clinically suspected diseases of the CNS were studied. The CSF samples were analyzed for gross examination, protein, sugar, adenosine deaminase (ADA) levels, microscopic examination and microbiologic examination. Culture was performed an all cases. A cytospin examination was done where malignancy (primary/metastasis) was suspected.

Results: Of the 215 samples analyzed, 97(45.1%) were found to have abnormal CSF findings. The maximum number of abnormal CSF samples were seen in the adolescents and adults (56.7%) age group. Very high protein levels were seen with bacterial, tuberculous and parasitic meningitis whereas fungal and viral meningitis showed moderate elevation of proteins. CSF ADA levels were raised in cases of tuberculous meningitis with mean value of 20.9 IU/L whereas all other types of meningitis showed normal level of ADA. A total of 3 cases of IVH and 2 cases of demyelinating disease were found in our study. Malignant cells were detected in two cases.

Conclusion: Thus, a study of CSF is vital as it provides an invaluable diagnostic window to the central nervous system atmosphere. A timely and appropriate analysis of CSF can help the clinician to direct the line of treatment and enhance patient care as well as reduce morbidity and mortality.