Spatial and temporal variation of routine parameters: pitfalls in the cerebrospinal fluid analysis in central nervous system infections
Abstract The cerebrospinal fluid (CSF) space is convoluted. CSF flow oscillates with a net flow from the ventricles towards the cerebral and spinal subarachnoid space. This flow is influenced by heartbeats, breath, head or body movements as well as the activity of the ciliated epithelium of the plex...
| Main Authors: | , , , |
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| Format: | Article |
| Language: | English |
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BMC
2022-07-01
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| Series: | Journal of Neuroinflammation |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12974-022-02538-3 |
| _version_ | 1828774569222078464 |
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| author | Marija Djukic Peter Lange Frank Erbguth Roland Nau |
| author_facet | Marija Djukic Peter Lange Frank Erbguth Roland Nau |
| author_sort | Marija Djukic |
| collection | DOAJ |
| description | Abstract The cerebrospinal fluid (CSF) space is convoluted. CSF flow oscillates with a net flow from the ventricles towards the cerebral and spinal subarachnoid space. This flow is influenced by heartbeats, breath, head or body movements as well as the activity of the ciliated epithelium of the plexus and ventricular ependyma. The shape of the CSF space and the CSF flow preclude rapid equilibration of cells, proteins and smaller compounds between the different parts of the compartment. In this review including reinterpretation of previously published data we illustrate, how anatomical and (patho)physiological conditions can influence routine CSF analysis. Equilibration of the components of the CSF depends on the size of the molecule or particle, e.g., lactate is distributed in the CSF more homogeneously than proteins or cells. The concentrations of blood-derived compounds usually increase from the ventricles to the lumbar CSF space, whereas the concentrations of brain-derived compounds usually decrease. Under special conditions, in particular when distribution is impaired, the rostro-caudal gradient of blood-derived compounds can be reversed. In the last century, several researchers attempted to define typical CSF findings for the diagnosis of several inflammatory diseases based on routine parameters. Because of the high spatial and temporal variations, findings considered typical of certain CNS diseases often are absent in parts of or even in the entire CSF compartment. In CNS infections, identification of the pathogen by culture, antigen detection or molecular methods is essential for diagnosis. |
| first_indexed | 2024-12-11T15:24:22Z |
| format | Article |
| id | doaj.art-126cdc4396664f5e82f84b3e76d820f6 |
| institution | Directory Open Access Journal |
| issn | 1742-2094 |
| language | English |
| last_indexed | 2024-12-11T15:24:22Z |
| publishDate | 2022-07-01 |
| publisher | BMC |
| record_format | Article |
| series | Journal of Neuroinflammation |
| spelling | doaj.art-126cdc4396664f5e82f84b3e76d820f62022-12-22T01:00:15ZengBMCJournal of Neuroinflammation1742-20942022-07-0119111810.1186/s12974-022-02538-3Spatial and temporal variation of routine parameters: pitfalls in the cerebrospinal fluid analysis in central nervous system infectionsMarija Djukic0Peter Lange1Frank Erbguth2Roland Nau3Institute of Neuropathology, University Medical CenterDepartment of Neurology, University Medical CenterParacelsus Medical Private UniversityInstitute of Neuropathology, University Medical CenterAbstract The cerebrospinal fluid (CSF) space is convoluted. CSF flow oscillates with a net flow from the ventricles towards the cerebral and spinal subarachnoid space. This flow is influenced by heartbeats, breath, head or body movements as well as the activity of the ciliated epithelium of the plexus and ventricular ependyma. The shape of the CSF space and the CSF flow preclude rapid equilibration of cells, proteins and smaller compounds between the different parts of the compartment. In this review including reinterpretation of previously published data we illustrate, how anatomical and (patho)physiological conditions can influence routine CSF analysis. Equilibration of the components of the CSF depends on the size of the molecule or particle, e.g., lactate is distributed in the CSF more homogeneously than proteins or cells. The concentrations of blood-derived compounds usually increase from the ventricles to the lumbar CSF space, whereas the concentrations of brain-derived compounds usually decrease. Under special conditions, in particular when distribution is impaired, the rostro-caudal gradient of blood-derived compounds can be reversed. In the last century, several researchers attempted to define typical CSF findings for the diagnosis of several inflammatory diseases based on routine parameters. Because of the high spatial and temporal variations, findings considered typical of certain CNS diseases often are absent in parts of or even in the entire CSF compartment. In CNS infections, identification of the pathogen by culture, antigen detection or molecular methods is essential for diagnosis.https://doi.org/10.1186/s12974-022-02538-3Cerebrospinal fluidBlood–CSF barrierBlood–brain barrierLactateIntrathecal immunoglobulin synthesisCSF flow |
| spellingShingle | Marija Djukic Peter Lange Frank Erbguth Roland Nau Spatial and temporal variation of routine parameters: pitfalls in the cerebrospinal fluid analysis in central nervous system infections Journal of Neuroinflammation Cerebrospinal fluid Blood–CSF barrier Blood–brain barrier Lactate Intrathecal immunoglobulin synthesis CSF flow |
| title | Spatial and temporal variation of routine parameters: pitfalls in the cerebrospinal fluid analysis in central nervous system infections |
| title_full | Spatial and temporal variation of routine parameters: pitfalls in the cerebrospinal fluid analysis in central nervous system infections |
| title_fullStr | Spatial and temporal variation of routine parameters: pitfalls in the cerebrospinal fluid analysis in central nervous system infections |
| title_full_unstemmed | Spatial and temporal variation of routine parameters: pitfalls in the cerebrospinal fluid analysis in central nervous system infections |
| title_short | Spatial and temporal variation of routine parameters: pitfalls in the cerebrospinal fluid analysis in central nervous system infections |
| title_sort | spatial and temporal variation of routine parameters pitfalls in the cerebrospinal fluid analysis in central nervous system infections |
| topic | Cerebrospinal fluid Blood–CSF barrier Blood–brain barrier Lactate Intrathecal immunoglobulin synthesis CSF flow |
| url | https://doi.org/10.1186/s12974-022-02538-3 |
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