Table Comparing Differences Between Ventricular CSF and Lumbar CSF in States of Health and Disease
| Parameter . | Ventricular CSF . | Lumbar CSF . | Normal Physiology . | Changes in Pathology . |
|---|---|---|---|---|
| Protein | Lower | Higher | Protein is progressively added through normal CSF circulation. 80% is derived from serum. | Increased ventricular–lumbar gradient in most disease processes; the magnitude of difference varies. |
| Normal ventricular:lumbar ratio of 0.25:0.60 in health. | ||||
| Glucose | Similar | Similar | Similar concentrations in healthy individuals. | Ventricular glucose significantly higher than lumbar glucose in most CNS infections. |
| Strong correlation to serum levels of glucose. | Multifactorial mechanisms and varies in disease states. Proposed mechanisms include increased microbial consumption, increased brain metabolic activity, consumption by WBC or malignant cells, and impaired function of the BBB & choroidal plexus. | |||
| WBCs | Lower | Higher | WBC gradient exists in health based on limited data. Mechanisms not clear. | Increased gradient in most disease processes, but degree depends on cause and location of abnormality in the CNS. |
| Reversal of gradient can occur with predominant ventricular pathology. | ||||
| Lactate | Similar | Similar | A mild cranio-caudal gradient exists, but much more uniform distribution through all compartments. | Elevated levels from CNS anaerobic glycolysis due to any condition that results in cerebral hypoperfusion, or produced by increased concentration of WBCs. |
| Produced within the CSF and generally independent of serum levels. | Retains more uniform distribution even in states of disease. |
| Parameter . | Ventricular CSF . | Lumbar CSF . | Normal Physiology . | Changes in Pathology . |
|---|---|---|---|---|
| Protein | Lower | Higher | Protein is progressively added through normal CSF circulation. 80% is derived from serum. | Increased ventricular–lumbar gradient in most disease processes; the magnitude of difference varies. |
| Normal ventricular:lumbar ratio of 0.25:0.60 in health. | ||||
| Glucose | Similar | Similar | Similar concentrations in healthy individuals. | Ventricular glucose significantly higher than lumbar glucose in most CNS infections. |
| Strong correlation to serum levels of glucose. | Multifactorial mechanisms and varies in disease states. Proposed mechanisms include increased microbial consumption, increased brain metabolic activity, consumption by WBC or malignant cells, and impaired function of the BBB & choroidal plexus. | |||
| WBCs | Lower | Higher | WBC gradient exists in health based on limited data. Mechanisms not clear. | Increased gradient in most disease processes, but degree depends on cause and location of abnormality in the CNS. |
| Reversal of gradient can occur with predominant ventricular pathology. | ||||
| Lactate | Similar | Similar | A mild cranio-caudal gradient exists, but much more uniform distribution through all compartments. | Elevated levels from CNS anaerobic glycolysis due to any condition that results in cerebral hypoperfusion, or produced by increased concentration of WBCs. |
| Produced within the CSF and generally independent of serum levels. | Retains more uniform distribution even in states of disease. |
Abbreviations: BBB, blood brain barrier; CNS, central nervous system; CSF, cerebrospinal fluid; WBC, white blood cell.
Table Comparing Differences Between Ventricular CSF and Lumbar CSF in States of Health and Disease
| Parameter . | Ventricular CSF . | Lumbar CSF . | Normal Physiology . | Changes in Pathology . |
|---|---|---|---|---|
| Protein | Lower | Higher | Protein is progressively added through normal CSF circulation. 80% is derived from serum. | Increased ventricular–lumbar gradient in most disease processes; the magnitude of difference varies. |
| Normal ventricular:lumbar ratio of 0.25:0.60 in health. | ||||
| Glucose | Similar | Similar | Similar concentrations in healthy individuals. | Ventricular glucose significantly higher than lumbar glucose in most CNS infections. |
| Strong correlation to serum levels of glucose. | Multifactorial mechanisms and varies in disease states. Proposed mechanisms include increased microbial consumption, increased brain metabolic activity, consumption by WBC or malignant cells, and impaired function of the BBB & choroidal plexus. | |||
| WBCs | Lower | Higher | WBC gradient exists in health based on limited data. Mechanisms not clear. | Increased gradient in most disease processes, but degree depends on cause and location of abnormality in the CNS. |
| Reversal of gradient can occur with predominant ventricular pathology. | ||||
| Lactate | Similar | Similar | A mild cranio-caudal gradient exists, but much more uniform distribution through all compartments. | Elevated levels from CNS anaerobic glycolysis due to any condition that results in cerebral hypoperfusion, or produced by increased concentration of WBCs. |
| Produced within the CSF and generally independent of serum levels. | Retains more uniform distribution even in states of disease. |
| Parameter . | Ventricular CSF . | Lumbar CSF . | Normal Physiology . | Changes in Pathology . |
|---|---|---|---|---|
| Protein | Lower | Higher | Protein is progressively added through normal CSF circulation. 80% is derived from serum. | Increased ventricular–lumbar gradient in most disease processes; the magnitude of difference varies. |
| Normal ventricular:lumbar ratio of 0.25:0.60 in health. | ||||
| Glucose | Similar | Similar | Similar concentrations in healthy individuals. | Ventricular glucose significantly higher than lumbar glucose in most CNS infections. |
| Strong correlation to serum levels of glucose. | Multifactorial mechanisms and varies in disease states. Proposed mechanisms include increased microbial consumption, increased brain metabolic activity, consumption by WBC or malignant cells, and impaired function of the BBB & choroidal plexus. | |||
| WBCs | Lower | Higher | WBC gradient exists in health based on limited data. Mechanisms not clear. | Increased gradient in most disease processes, but degree depends on cause and location of abnormality in the CNS. |
| Reversal of gradient can occur with predominant ventricular pathology. | ||||
| Lactate | Similar | Similar | A mild cranio-caudal gradient exists, but much more uniform distribution through all compartments. | Elevated levels from CNS anaerobic glycolysis due to any condition that results in cerebral hypoperfusion, or produced by increased concentration of WBCs. |
| Produced within the CSF and generally independent of serum levels. | Retains more uniform distribution even in states of disease. |
Abbreviations: BBB, blood brain barrier; CNS, central nervous system; CSF, cerebrospinal fluid; WBC, white blood cell.
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