Cerebrospinal fluid (CSF) analysis

The laboratory investigation of CSF has been developed over the years as a diagnostic tool for many neurological diseases. Although minimally invasive, CSF is obtained with a traumatic procedure; therefore, the whole laboratory process should be established to maximize the analytical performance. Based on the review of international guidelines and on the experience developed by members of the SIBioC Working Group, the present document provides practical information for laboratory professionals to better address the CSF analysis in different diagnostic situations. The report faces the pathophysiologic meaning of the determination of biochemical parameters, such as glucose, lactate, albumin, immunoglobulins, beta-amyloid, tau protein, and the cellular content, providing also evidence on the proper methodological approach. Quantitative and qualitative CSF parameters useful to diagnose an inflammatory process of the central nervous system are discussed, particularly with reference to multiple sclerosis. Indications on how laboratory data should be presented to meet international recommendations are also included.