From: S1 guidelines “lumbar puncture and cerebrospinal fluid analysis” (abridged and translated version)
Analytical step | Parameters | Indication/Remarks |
---|---|---|
Emergency analysis | Appearance (if contaminated with blood, 3-tubes test), cell count, total protein, lactate | Acute inflammation, bacterial or viral, cerebral bleeding (SAH, ICH) |
Basic analysis | Quotients Albumin, IgG, IgA, IgM, and oligoclonal bands | Intrathecal inflammation, Blood-CSF barrier function |
Differential cell count | Differentiation of inflammation, bleeding, and neoplastic involvement | |
Gram staining and culture | Pathogen detection (bacteria, fungi) | |
Extended analysis | Pathogen-specific antibody (Antibody index) | Infection or autoimmune disease |
CNS-specific proteins | Neurodegenerative diseases (AD, CJD, ALS, Narcolepsy, etc.) | |
Immune cytology, tumor markers | Tumor: confirmation and subtyping | |
Antigen detection | Pathogen detection (bacteria, fungi) | |
PCR | Standard for viruses and Tbc, some other bacteria and parasitesa |