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 is in the space around the spinal cord and brain.
How the Test is Performed
A sample of CSF is needed [1 to 5 milliliters (ml)]. A lumbar puncture (spinal tap) is the most common way to collect this sample. Rarely, other methods are used for collecting CSF such as:
Lumbar puncture
Cerebrospinal fluid (CSF) collection is a test to look at the fluid that surrounds the brain and spinal cord. CSF acts as a cushion, protecting the b...
- 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 lab for evaluation.
Why the Test is Performed
The CSF cell count may help detect:
-
Meningitis and infection of the brain or spinal cord
Meningitis
Meningitis is an infection of the membranes covering the brain and spinal cord. This covering is called the meninges.
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Tumor, abscess, or area of tissue death (infarct)
Tumor
A tumor is an abnormal growth of body tissue. Tumors can be cancerous (malignant) or noncancerous (benign).
Read Article Now Book Mark ArticleAbscess
An abscess is a collection of pus in any part of the body. In most cases, the area around an abscess is swollen and inflamed.
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- Bleeding into the spinal fluid (secondary to subarachnoid hemorrhage)
Subarachnoid hemorrhage
Subarachnoid hemorrhage is bleeding in the area between the brain and the thin tissues that cover the brain. This area is called the subarachnoid sp...
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Normal Results
The normal white blood cell count is from 0 to 5. The normal red blood cell count is 0.
Note: Normal value ranges may vary slightly among different labs. Talk to your health care provider about the meaning of your specific test results.
The examples above show the common measurements for results for these tests. Some labs 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
Encephalitis
Encephalitis is irritation and swelling (inflammation) of the brain, most often due to infections.
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-
Meningitis
Meningitis
Meningitis is an infection of the membranes covering the brain and spinal cord. This covering is called the meninges.
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Multiple sclerosis
Multiple sclerosis
Multiple sclerosis (MS) is an autoimmune disease that affects the brain and spinal cord (central nervous system).
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-
Tumor
Tumor
A tumor is an abnormal growth of body tissue. Tumors can be cancerous (malignant) or noncancerous (benign).
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Neurosarcoidosis
Neurosarcoidosis
Neurosarcoidosis is a form of sarcoidosis, in which inflammation occurs in the brain, spinal cord, and other areas of the nervous system.
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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.
Additional conditions which this test may help diagnose include:
-
Arteriovenous malformation (cerebral)
Arteriovenous malformation (cerebral)
A cerebral arteriovenous malformation (AVM) is an abnormal connection between the arteries and veins in the brain that usually forms before birth....
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Cerebral aneurysm
Cerebral aneurysm
An aneurysm is a weak area in the wall of a blood vessel that causes the blood vessel to bulge or balloon out. When an aneurysm occurs in a blood ve...
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Delirium
Delirium
Delirium is sudden severe confusion due to rapid changes in brain function that can occur with physical or mental illness.
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Guillain-Barré syndrome
Guillain-Barré syndrome
Guillain-Barré syndrome (GBS) is a serious health problem that occurs when the body's defense (immune) system mistakenly attacks part of the peripher...
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Stroke
Stroke
A stroke occurs when blood flow to a part of the brain stops. A stroke is sometimes called a "brain attack. " If blood flow is cut off for longer th...
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Neurosyphilis
Neurosyphilis
Neurosyphilis is a bacterial infection of the brain or spinal cord. It usually occurs in people who have had untreated syphilis for many years....
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Primary lymphoma of the brain
Primary lymphoma of the brain
Primary lymphoma of the brain is cancer of white blood cells that starts in the brain.
ImageRead Article Now Book Mark Article - Seizure disorders, including epilepsy
Epilepsy
Epilepsy is a brain disorder in which a person has repeated seizures over time. Seizures are episodes of uncontrolled and abnormal electrical activi...
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Spinal tumor
Spinal tumor
A spinal tumor is a growth of cells (mass) in or around the spinal cord.
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Lyme disease
Lyme disease
Lyme disease is a bacterial infection that is spread through the bite of one of several types of ticks.
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Reviewed By
Joseph V. Campellone, MD, Department of Neurology, Cooper Medical School at Rowan University, Camden, NJ. Review provided by VeriMed Healthcare Network. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.
De Luca GC, Griggs RC, Johnston SC. Approach to the patient with neurologic disease. In: Goldman L, Cooney KA, eds. Goldman-Cecil Medicine. 27th ed. Philadelphia, PA: Elsevier; 2024:chap 366.
Karcher DS, McPherson RA. Cerebrospinal, synovial, serous body fluids, and alternative specimens. In: McPherson RA, Pincus MR, eds. Henry's Clinical Diagnosis and Management by Laboratory Methods. 24th ed. Philadelphia, PA: Elsevier; 2022:chap 30.
Rosenberg GA. Brain edema and disorders of cerebrospinal fluid circulation. In: Jankovic J, Mazziotta JC, Pomeroy SL, Newman NJ, eds. Bradley and Daroff's Neurology in Clinical Practice. 8th ed. Philadelphia, PA: Elsevier; 2022:chap 88.
Schnapp BH, Jewell C. Central nervous system infections. In: Walls RM, ed. Rosen's Emergency Medicine: Concepts and Clinical Practice. 10th ed. Philadelphia, PA: Elsevier; 2023:chap 95.
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