Cerebrospinal fluid: sampling

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Sections available in full article Introduction, Uses, Time required, Decision taking, Requirements, Personnel, Materials required, Preparation, Procedure, Sources, Vetstream contributor(s),
Contributors Mr Harry Scott BVSc, MIBiol, CertSAD, DSAS(Orth), FRCVS RCVS Specialist in Small Animal Orthopaedics
Synonyms CSF tap, cerebromedullary cistern

Introduction

  • Central spinal fluid (CSF) produced by active secretion as well as selective filtration from blood by choroid plexus. Fluid should be clear and transparent (or colorless) and should not clot.

Uses

  • Diagnosis of central nervous system disease and evaluation of therapy.
  • Therapeutic drainage of CSF at high pressure, or blood or exudate.

Advantages

  • Ease of collection.
  • Full fluid analysis can be performed.
  • Enables injection of contrast material for imaging.

Disadvantages

  • Best results obtained during acute phase of disease.
  • Requires general anesthesia.
  • Risk of puncturing brainstem if unskilled.
  • Risk of brain herniation, which may be fatal, in cases of acute cerebral trauma due to hemorrhage and edema   →   increased intracranial pressure.
  • Similarly, risk of brain herniation in cases of intracranial neoplasia .
  • Risk of introducing infection - strict asepsis mandatory.
  • Life-threatening complications .

Requirements

Materials required

Ideal equipment

  • Manometer (rarely needed).

Minimum consumables

  • 1.5 inch, 20-22G needle.
  • Fluid container(s).

Ideal consumables

  • 22G spinal needle.
  • 2 plain and 1 EDTA tubes.
  • Three-way stopcock.

Preparation

  • 15-20 minutes for site preparation and induction of anesthesia.

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