Differential count of cerebrospinal fluid cells

Microscopic examination of cerebrospinal fluid is generally based on cell counting and white blood cell classification. Cerebrospinal fluid does not contain red blood cells, no white blood cells or very small amounts of white blood cells. In the case of central nervous system diseases, the number of cells in the cerebrospinal fluid increases, and the types of elevated white blood cells change. Therefore, doing cerebrospinal fluid microscopy can reflect the different nature of the disease. Basic Information Specialist classification: examination classification: cerebrospinal fluid examination Applicable gender: whether men and women apply fasting: fasting Tips: When taking ibuprofen, sulfamethoxazole, sulindac and other drugs, the number of macrophages in cerebrospinal fluid can be increased. Normal value Cell sorting counts 40% to 80% of lymphocytes, 15% to 45% of monocytes, and 0 to 6% of neutrophils. Other cells are rare. Clinical significance Cellular counts of cerebrospinal fluid contribute to the diagnosis and differential diagnosis of central nervous system diseases. 1. Neutrophil enlargement is more common in bacterial suppurative meningitis, Changda (1 ~ 20) × 10 ^ 9 / L; early viral meningoencephalitis, early tuberculous or fungal meningitis, rarely more than 1 ×109/L. Also seen after central nervous system bleeding. Repeated lumbar puncture, subarachnoid injection of foreign body, chronic myeloid leukemia and central nervous system metastatic tumor. 2. Lymphocytosis is seen in viral encephalitis, syphilitic meningoencephalitis, tuberculous or fungal meningitis, parasitic diseases, and the like. At this time, mixed cell reactions (including plasma cells, macrophages, monocytes, etc.) often occur, and the number of cells often reaches 1×10^9/L. Also seen in non-infectious diseases such as multiple sclerosis and polyneuritis. 3. Eosinophils are found in parasitic and fungal infections, acute polyneuritis, allergic reactions, and brain lymphocytic leukemia. 4. Basophils are found in parasitic infections, and chronic myeloid leukemia involves the meninges. 5. Monocytes often increase with the increase of lymphocytes and plasma cells. 6. Macrophages are found in tuberculous or fungal meningitis and respond to red blood cells, foreign bodies, fats, etc. in the cerebrospinal fluid. Intake of ibuprofen, sulfamethoxazole, sulindac and other drugs can increase the number of cells in the cerebrospinal fluid. Precautions When taking drugs such as ibuprofen, sulfamethoxazole, sulindac, etc., the number of macrophages in the cerebrospinal fluid can be increased. Inspection process In general, after the white blood cell count of the cerebrospinal fluid, the cells of the single nucleus (lymphocytes and monocytes) and the cells of the plurality of nuclei are counted according to the morphology of the nucleus under high magnification. Count 100 cells, expressed as a percentage. If there are less than 100 white blood cells, the number of mononuclear and multinucleated cells should be directly written. Under special circumstances, if the cell morphology is abnormal or the number is too large (meningeal leukemia or tumor), if it can not be directly classified, the centrifugation sediment smear can be added to normal serum 1 drop to make a uniform film, then methylene blue-I Both red staining and Wright staining can be used. Cells with abnormal morphology should be described with a focus to aid clinical diagnosis. Not suitable for the crowd 1. If there is obvious papilledema or cerebral palsy, contraindications are contraindicated. 2. Patients who are in shock, exhaustion or endangered state and local skin inflammation, and lesions in the posterior cranial fossa are contraindicated. Adverse reactions and risks If the patient has symptoms such as breathing, pulse, or abnormal color during puncture, stop the operation immediately and deal with it accordingly.