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CSF cell count

A CSF cell count is a test to measure the number of red and white blood cells that are in cerebrospinal fluid (CSF). CSF is a clear fluid that in the space around the spinal cord and brain.

How the Test is Performed

A lumbar puncture (spinal tap) is the most common way to collect this sample. Rarely, other methods are used for collecting CSF such as:

  • Cisternal puncture
  • Ventricular puncture
  • Removal of CSF from a tube that is already in the CSF, such as a shunt or ventricular drain.

After the sample is taken, it is sent to a lab for evaluation.

Why the Test is Performed

The CSF cell count may help detect:

  • Meningitis and infection of the brain or spinal cord
  • Tumor, abscess, or area of tissue death (infarct)
  • Inflammation
  • Bleeding into the spinal fluid

Normal Results

The normal white blood cell count is between 0 and 5. The normal red blood cell count is 0.

Note: Normal value ranges may vary slightly among different laboratories. Talk to your doctor about the meaning of your specific test results.

The examples above show the common measurements for results for these tests. Some laboratories use different measurements or may test different specimens.

What Abnormal Results Mean

An increase of white blood cells indicates infection, inflammation, or bleeding into the cerebrospinal fluid. Some causes include:

  • Abscess
  • Encephalitis
  • Hemorrhage
  • Meningitis
  • Multiple sclerosis
  • Other infections
  • Stroke
  • Tumor

Finding red blood cells in the CSF may be a sign of bleeding. However, red blood cells in the CSF may also be due to the spinal tap needle hitting a blood vessel.

Additional conditions which this test may help diagnose include:

References

Griggs RC, Jozefowicz RF, Aminoff MJ. Approach to the patient with neurologic disease. In: Goldman L, Schafer AI, eds. Goldman's Cecil Medicine. 24th ed. Philadelphia, PA: Saunders Elsevier; 2011:chap 403.

Rosenberg GA. Brain edema and disorders of cerebrospinal fluid circulation. In: Daroff RB, Fenichel GM, Jankovic J, Mazziotta JC, eds. Bradley's Neurology in Clinical Practice. 6th ed. Philadelphia, PA: Saunders Elsevier; 2012:chap 59.

Updated: 5/28/2013

Luc Jasmin, MD, PhD, FRCS (C), FACS, Department of Neurosurgery at Cedars-Sinai Medical Center, Los Angeles CA; Department of Surgery at Los Robles Hospital, Thousand Oaks CA; Department of Surgery at Ashland Community Hospital, Ashland OR; Department of Surgery at Cheyenne Regional Medical Center, Cheyenne WY; Department of Anatomy at UCSF, San Francisco CA. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Bethanne Black, and the A.D.A.M. Editorial team.


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