Navigate Up

Orthopaedics Center - A-Z Index

#
I
Q
Y
Z

Print This Page

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 circulates in the space surrounding the spinal cord and brain.

How the test is performed

A sample of CSF is needed. A lumbar puncture (spinal tap) is the most common way to collect this sample. For information on this procedure, see the article on lumbar puncture .

Other methods for collecting CSF are rarely used, by may be recommended in some cases. They include:

  • 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 laboratory for evaluation.

How to prepare for the test

See: Lumbar puncture

How the test will feel

See: Lumbar puncture

Why the test is performed

The CSF cell count may help diagnose meningitis and infection of the brain or spinal cord, a tumor , abscess , or area of tissue death (infarct), and it helps identify inflammation. The cell count may also help identify bleeding in the spinal fluid.

Normal Values

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 while entering the skin or dura.

It is important to see if the red blood cell count returns to normal in samples taken later in the procedure as opposed to earlier. A ratio of the red blood cells to the white blood cells is also calculated to help with diagnosis.

Additional conditions which this test may help diagnose include:

What the risks are

Risks of lumbar puncture include:

  • Allergic reaction to the anesthetic
  • Discomfort during the test
  • Headache after the test
  • Bleeding into the spinal canal
  • Infection

Brain herniation may occur if performed on a person with a mass in the brain such as a tumor or abscess. This can result in brain damage or death. For this reason, a lumbar puncture is not done if other tests show signs of a tumor or abscess.

There may be temporary leg discomfort if a nerve root is irritated by the needle. This passes when the needle is withdrawn.

References

Griggs RC, Jozefowicz RF, Aminoff MJ. Approach to the patient with neurologic disease. In: Goldman L, Ausiello D, eds. Cecil Medicine. 23rd ed. Philadelphia, Pa: Saunders Elsevier. 2007: chap 418.

Rosenberg GA. Brain edema and disorders of cerebrospinal fluid circulation. In: Bradley WG, Daroff RB, Fenichel GM, Jankovic J, eds. Bradley: Neurology in Clinical Practice. 5th ed. Philadelphia, Pa: Butterworth-Heinemann Elsevier; 2008:chap 63.

Updated: 4/30/2011

Kevin Sheth, MD, Department of Neurology, University of Maryland School of Medicine, Baltimore, MD. Review provided by VeriMed Healthcare Network. Also reviewed by David C. Dugdale, III, MD, Professor of Medicine, Division of General Medicine, Department of Medicine, University of Washington School of Medicine;David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.


©  UPMC | Affiliated with the University of Pittsburgh Schools of the Health Sciences
Supplemental content provided by A.D.A.M. Health Solutions. All rights reserved.

For help in finding a doctor or health service that suits your needs, call the UPMC Referral Service at 412-647-UPMC (8762) or 1-800-533-UPMC (8762). Select option 1.

UPMC is an equal opportunity employer. UPMC policy prohibits discrimination or harassment on the basis of race, color, religion, ancestry, national origin, age, sex, genetics, sexual orientation, marital status, familial status, disability, veteran status, or any other legally protected group status. Further, UPMC will continue to support and promote equal employment opportunity, human dignity, and racial, ethnic, and cultural diversity. This policy applies to admissions, employment, and access to and treatment in UPMC programs and activities. This commitment is made by UPMC in accordance with federal, state, and/or local laws and regulations.

Medical information made available on UPMC.com is not intended to be used as a substitute for professional medical advice, diagnosis, or treatment. You should not rely entirely on this information for your health care needs. Ask your own doctor or health care provider any specific medical questions that you have. Further, UPMC.com is not a tool to be used in the case of an emergency. If an emergency arises, you should seek appropriate emergency medical services.

For UPMC Mercy Patients: As a Catholic hospital, UPMC Mercy abides by the Ethical and Religious Directives for Catholic Health Care Services, as determined by the United States Conference of Catholic Bishops. As such, UPMC Mercy neither endorses nor provides medical practices and/or procedures that contradict the moral teachings of the Roman Catholic Church.

© UPMC
Pittsburgh, PA, USA UPMC.com