Changes in the cerebrospinal fluid in diseases of the central nervous system
Purulent meningitis – the status and composition of cerebrospinal fluid
On the second or third day of the disease appears pleocytosis, sometimes so pronounced, that the number of cells is beyond counting; cerebrospinal liquid has the form of pus.
At the height of the disease is dominated by neutrophilic granulocytes, when recovery appears lymphocytes and plasma cells. Sharply increased protein content (sometimes up to 2.5-3 g / l), globulin response positive. Colloidal reaction inflammatory or inflammatory degenerative type. When combined with a high level of protein with low pleocytosis forecast is considered to be unfavorable. Glucose and chlorides reduced.
Characteristically increased activity of lactate dehydrogenase (LDH), aspartate aminotransferase (IS), alanine aminotransferase (GOLD), aldolase, acid and alkaline phosphatases.
When bacterioscopic and bacteriological examination in sluchas primary purulent meningitis, usually, found meningococcus.
Purulent meningitis secondary It can be caused by streptococcus pneumoniae (pneumococci), streptococci, staphylococci, and very rarely - yeasts.
Tuberculous meningitis – the status and composition of cerebrospinal fluid
In this disease, cerebrospinal fluid often transparent, Colorless, sometimes slightly opalescent. When standing in a cool place it forms a thin film of fibrin. At the beginning of the disease small cell count, during the clinical manifestations number of cells increases to 200 in 1 l cerebrospinal fluid and more. Pleocytosis is lymphocytic character. The protein content is usually somewhat increases, sometimes it remains normal. Reactions Nonna-Apelt and Pandey are positive.
For the initial stage of the disease characterized by increased content of α1-globulin and decreasing α2-globulin, further increases the level of all factions globulinovy.h. Colloidal reaction at the beginning of the disease is usually inflammatory type, the progression of the pathological process - degenerative or mixed. Significantly reducing the level of glucose and chlorides. In some cases, a positive reaction tryptophan and Levinson. Pathognomonic is the discovery in fibrinous film Mycobacterium tuberculosis (60-90 % cases).
Hydromeningitis – the status and composition of cerebrospinal fluid
This disease is usually characterized by colorless cerebrospinal fluid with low pleocytosis by lymphocytes, moderately high in protein (to 0,6 g / l), normal or slightly reduced levels of glucose. Fibrinous film rarely falls. Colloidal reaction often normal or slabovy-expression of inflammatory.
In secondary serous (vyrusnom) meningitis, along with the presence of lymphocytes in the cerebrospinal fluid revealed a significant number of plasma cells. The microflora is not detected.
Epidemic encephalitis – the status and composition of cerebrospinal fluid
In the study of cerebrospinal fluid is sometimes blurred and marked xanthosis, but more often it is transparent, Colorless.
Moderate cytosis (40-60 cells 1 l) by lymphocytes. The protein content of normal or slightly elevated, globulin weakly positive reaction, colloidal reactions are normal, Sometimes weakly positive inflammatory, less degenerative type. Typically an increase in γ-globulins. Glucose levels are normal or elevated, the chloride content is normal.
When viral neuroinfection (in the acute period) in the cerebrospinal fluid mononuclear cells predominate (67-68 % lymphocytes and lymphoid cells, 3-4 % plazmotsitov, 5-19 % monocytes and macrophages), while the share accounted poliiuklearov 6-10 %. It is shown to promote cell transformation elements in macrophages and type blastoid, which is not observed in bacterial (purulent) meninges.
Encephalopyosis – the status and composition of cerebrospinal fluid
In this disease state number of cells in the cerebrospinal fluid it depends on the stage of the disease. In the initial stage of the abscess observed neutrophilic pleocytosis and slight increase in protein levels. As the abscess capsule cell count is reduced by reducing the number of neutrophilic granulocytes. The cerebrospinal fluid is dominated by lymphocytes, protein content increases. Often there is a discrepancy between the amount of protein and the number of cells: the number of cells in normal protein levels increased.
Breakthrough abscess in space, which circulates the cerebrospinal fluid, characterized by increased cell count to 500-1000 cells 1 l or more by neutrophilic granulocytes. There macrophages and polyblasts. Many destroyed cells, detritus, crystals can be detected gematoidina. When recovery is gradually reduced the number of cells, and the protein content is reduced.
Cysticercosis of the brain – the status and composition of cerebrospinal fluid
In the diagnosis of cysticercosis of the brain are important changes in the cellular composition of cerebrospinal fluid, and the most characteristic of the disease lymphocytic pleocytosis with many histiocytes, macrophages, the presence of plasma cells, endothelial cells of the arachnoid mater, eosinophilic granulocytes.
For the diagnosis of cysticercosis used complement fixation to a specific antigen, by indirect fluorescent antibody and hemagglutination.
