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Lumbar Puncture

Results

A lumbar puncture camera.gif (also called a spinal tap) is a procedure to collect and look at the fluid (cerebrospinal fluid, or CSF) surrounding the brain and spinal cord. Many different tests can be done on the CSF. Some results will be ready right away, some will take a few hours after the procedure, and others will take several weeks.

The normal values listed here—called a reference range—are just a guide. These ranges vary from lab to lab, and your lab may have a different range for what's normal. Your lab report should contain the range your lab uses. Also, your doctor will evaluate your results based on your health and other factors. This means that a value that falls outside the normal values listed here may still be normal for you or your lab.

Normal results1

Appearance:

CSF is normally clear and colorless.

Pressure:

Normal CSF pressure in the lower back for an adult ranges from 90–180 millimeters (mm) water. For children younger than 8 years old, the normal opening pressure range is 10–100 mm water.

Protein:

The normal protein content of CSF in an adult's lower back (lumbar) region is 15–45 milligrams per deciliter (mg/dL) or 150–450 milligrams per liter (mg/L). Older adults and children may have higher values that are still in the normal range.

Glucose:

The normal range for glucose content in the CSF is about 60% of the blood glucose level. The levels may be slightly increased if the person has just eaten.

Cell counts:

Normal CSF contains no red blood cells (RBCs). The white blood cell (WBC) count for adults is 0–5 WBCs per cubic millimeter (mm3). Children may normally have a higher WBC count. No neutrophils are present.

Other results:

No infectious organisms (such as bacteria, fungi, or a virus) are found in the CSF sample. No tumor cells are present.

Abnormal results

Appearance:

Blood in the CSF can result from bleeding (hemorrhage) in or around the spinal cord or brain, but it may also be caused by tiny blood vessel poked during the spinal tap. If a brain hemorrhage has occurred, the color of the CSF may change from red to yellow to brown over several days. Bleeding caused by the lumbar puncture itself will show more red blood cells in the first sample collected than in later samples. Cloudy CSF may mean an infection (such as meningitis or a brain abscess) is present.

Pressure:

High CSF pressure may occur as a result of swelling (edema) or bleeding (hemorrhage) in the brain, infection (such as meningitis), stroke, or other circulatory problems. Below-normal pressure may mean a blocked spinal canal.

Protein:

A high level of protein may be caused by bleeding in the CSF, a tumor or spread of a cancer from another area of the body, diabetes, infection, injury, Guillain-Barré syndrome, severe hypothyroidism, or other nerve diseases. An increase in antibodies (immunoglobulins) may be caused by inflammation in people who have multiple sclerosis, immune system disorders, or other bacterial and viral diseases.

Glucose:

Low glucose levels in the CSF are abnormal and may be caused by bacterial meningitis. Viral meningitis does not often cause low glucose levels in the CSF. Brain hemorrhage may also cause low glucose levels several days after bleeding begins. Higher-than-normal glucose levels are often caused by diabetes.

Cell counts:

Red blood cells (RBCs) in the CSF can result from bleeding. High levels of white blood cells (WBCs) can indicate meningitis. Tumor cells and abnormal levels of white blood cells can show cancer is present.

Other results:

Antibodies, bacteria, or other organisms in the CSF means that an infection (such as syphilis) or disease is present. Bacterial markers (bacterial antigens) that show up mean meningitis. Cultures or stains of the CSF may also help show the cause of meningitis or encephalitis.

Your doctor may order other special tests on the CSF fluid depending on your symptoms and past health.

WebMD Medical Reference from Healthwise

Last Updated: August 30, 2012
This information is not intended to replace the advice of a doctor. Healthwise disclaims any liability for the decisions you make based on this information.

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