Differentiation of cerebrospinal fluid in three types of encephalitis

Cerebrospinal fluid is a substance produced by the choroid plexus in the ventricular system through hemodialysis. By examining this substance, encephalitis can be identified and diagnosed to a certain extent. For example, the cerebrospinal fluid of a normal person should be colorless and transparent. If red cerebrospinal fluid appears, it means that ventricular hemorrhage has occurred. If it is yellow, neuritis, spinal canal infarction, etc. may occur. The cerebrospinal fluid of encephalitis can be examined and identified.

Differential diagnosis of cerebrospinal fluid in encephalitis

The normal cerebrospinal fluid volume is: 90--150ml; newborn baby is 10--60ml. Color: colorless and transparent liquid.

A Red:

Bleeding. Seen in puncture injuries, subarachnoid hemorrhage, and intraventricular hemorrhage. Puncture injuries are bloody at first and then gradually become lighter. Subarachnoid hemorrhage and intraventricular hemorrhage are always bloody.

B Yellow:

Subarachnoid hemorrhage causes red blood cells to dissolve and turn yellow; or in case of spinal infarction, polyneuritis, or meningitis, the protein content increases and turns yellow.

C Milky white:

Seen in purulent meningitis caused by Clostridium pyogenes.

D Light green:

Meningitis caused by Pseudomonas aeruginosa.

E Others:

Brown and black are seen in meningeal melanoma.

Transparency: Clear and transparent. A. Slightly turbid: viral meningitis, Japanese encephalitis, central nervous system syphilis. B. Ground glass opacity: tuberculous meningitis. C Milky white turbidity: purulent meningitis. Concrete: None. A Inflammation B Tuberculous meningitis C Subarachnoid infarction occurs when it is a yellow jelly.

Examination of cerebrospinal fluid. The cerebrospinal fluid pressure measured after puncture is 0.78-1.76 kPa (80-180 mm water column) for adults in the lateral position, 0.39-0.98 kPa (40-100 mm water column) for children, and 0.098-0.14 kPa (10-14 mm water column) for newborns. When observing the initial pressure, attention should be paid to the presence of respiratory pulsation (0.098-0.197 kPa (10-20 mm water column) and pulsatile pulsation (0.02-0.039 kPa (2-4 mm water column) of cerebrospinal fluid surface pulsation produced with breathing). When the former disappears, it indicates obstruction in the spinal canal or foramen magnum hernia, and caution should be exercised.

Common encephalitis in children include viral encephalitis, purulent encephalitis, and of course tuberculous encephalitis. To confirm any of these three types of encephalitis, it is necessary to rely on cerebrospinal fluid examination, that is, to do a lumbar puncture, extract cerebrospinal fluid and do an examination to confirm whether it is encephalitis. Of course, it must also be combined with clinical symptoms.