What Is Cerebrospinal Fluid Glucose?

The glucose content in the cerebrospinal fluid depends on the following factors: blood glucose concentration; permeability of the blood-brain barrier; the degree of glucose hydrolysis in the cerebrospinal fluid; the function of carrying the operating system.

Name: Cerebrospinal fluid glucose

category: Cerebrospinal fluid

Normal cerebrospinal fluid glucose

Infant 3.9-5.0mmol / L; Child 2.8-4.5mmol / L; Adult 3.6-4.5mmol / L.

Clinical significance of cerebrospinal fluid glucose

Abnormal results: mild or moderate reduction: syphilis, meningeal multiple malignant tumor metastasis.

Significant reduction: meningitis (bacterial, tuberculous, cryptococcus neoformans).

People to be tested: People with stiff neck, severe headache, loss of appetite, unconsciousness, vomiting, convulsions, burnout, sleepiness, light sensitivity, small blood spots on the skin, skin rash symptoms.

Cerebrospinal fluid glucose precautions

Before the test: The subject should stop taking all drugs and maintain a reasonable diet and schedule.

When checking: Eliminate tension and anxiety.

Unsuitable: No.

Cerebrospinal fluid glucose examination process

(1) The patient lies on a hard bed with the back perpendicular to the table, the head flexed forward as far as possible, the chest clasped with both hands against the abdomen, so that the torso is as arched as possible; With the other hand holding the lower limbs of the popliteal fossa and holding it tightly, so that the spine is as convex as possible to widen the intervertebral space and facilitate needle insertion.

(2) Determine the puncture point, usually the intersection of the line connecting the highest point of the bilateral sacroiliac spine and the posterior midline as the puncture point, which is equivalent to the 3-4 lumbar spinous process space, and sometimes it can be in the previous or next Lumbar spine space.

(3) After routine disinfection of the skin, wear sterile gloves, cover towels, and use layered local anesthesia with 2% lidocaine from the skin to the intervertebral ligament.

(4) The surgeon fixes the puncture point skin with his left hand, and slowly inserts the puncture needle with his right hand in a direction perpendicular to the back and the tip of the needle slightly obliquely toward the head. The depth of needle insertion is about 4-6cm for adults and 2-4cm for children. When the needle passes through the ligament and dura, the resistance suddenly disappears. At this time, the needle core can be slowly withdrawn (to prevent the cerebrospinal fluid from flowing out quickly, causing cerebral hernia), and the cerebrospinal fluid can be seen to flow out.

(5) Connect the manometer to measure the pressure before discharging. Normal lateral lying cerebrospinal fluid pressure is 70-180mmH2O (0.098Kpa = 10mmH2O) or 40-50d / min. If you continue the queckenstedt test, you can know whether the subarachnoid space is blocked. That is, after the initial pressure is measured, the assistant first compresses the carotid artery on one side for about 10 seconds, then the other side, and finally presses the carotid artery on both sides at the same time. After the carotid artery is compressed under normal conditions, the cerebrospinal fluid pressure rapidly doubles immediately, and 10-20s after the pressure is released, it quickly drops to the original level. Elevating cerebrospinal fluid pressure is positive for obstruction test, showing that the subarachnoid space is completely blocked. If the pressure rises slowly after pressure is applied, then slowly decreases after relaxation, indicating incomplete obstruction. However, those with elevated intracranial pressure are banned from this test.

(6) Remove the pressure measuring tube and collect 2-5ml cerebrospinal fluid for examination; if culture is required, use a sterile test tube to retain the specimen.

(7) After the operation, insert the needle core and pull out the puncture needle together, cover the sterile gauze, and fix it with adhesive tape.

(8) Go to the supine position for 4-6 hours, so as not to cause low intracranial pressure headache after operation.
Quantitative determination of glucose oxidase or hexokinase. If the specimen needs to be stored for a long time, an appropriate amount of sodium fluoride can be added to inhibit the use of glucose by cells or bacteria.

Cerebrospinal fluid glucose related diseases

Meningitis, diabetes, etc.

Cerebrospinal fluid glucose related symptoms

Measles face, stinging and itching skin with urticaria, rashes, flushing skin similar to urticaria, weight loss, headache, fatigue, polyuria, fever, etc.

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