Cerebrospinal Fluid (CSF) Sample Requirements

Chemical Pathology

CSF sample requirements

• DO NOT SEND ANY OF THESE SAMPLES VIA THE AIR TUBE. SAMPLES MUST BE TAKEN BY HAND TO PATHOLOGY RECEPTION
  
• IF PRION DISEASE OR TB IS SUSPECTED PLEASE NOTE THIS ON ALL REQUEST FORMS. FOR SUSPECTED PRION DISEASE NOTE THAT THE EDINBURGH LABORATORY MUST BE CONTACTED BEFORE PERFORMING LUMBAR PUNCTURE.
  
• CSF SAMPLES FOR SUSPECTED SUBARACHNOID HAEMORRHAGE MUST BE PROTECTED FROM THE LIGHT. Please also indicate result of CT scan and date and time of onset of headache.
  

Please see individual test pages for more information, including reference ranges (access test page links below table)

Access links for more details on individual tests:

Microbiology investigations

• Department: Microbiology
  
• Preferred tap: Tap #1 and #3
  
• CSF volume: 1 mL in EACH (25 drops each)
  
• Sample tube: Plain Universal container
  

Protein

• Department: Chemical Pathology
  
• Preferred tap: Tap #2
  
• CSF volume: 0.25 mL (6 drops)
  
• Sample tube: Plain Universal container. Tubes containing gel or anticoagulant are not suitable for analysis of CSF protein.

Glucose

• Department: Chemical Pathology
  
• Preferred tap: Tap #2
  
• CSF volume: 0.25 mL (6 drops)
  
• Sample tube: Fluoride-oxalate tube (grey top) sent immediately to the laboratory.

Oligoclonal bands

• Department: Chemical Pathology
  
• Preferred tap: Tap #4
  
• CSF volume: 0.5 mL (12 drops)
• Sample tube: Plain Universal container for CSF and blood in a 5mL gold top tube (or rust top for the Acute Unit).

Spectrophotometry for xanthochromia

• Department: Chemical Pathology
  
• Preferred tap: Tap #4
  
• CSF volume: 1 mL (25 drops)
• Sample tube: Plain Universal container for CSF and blood in a 5mL gold top tube (or rust top for the Acute Unit) for liver function tests. CSF Sample must be protected from light (wrap sample in foil or hand towel after labelling). Do not send in air tube.

Cytology

• Department: Cytopathology
  
• Preferred tap: Any
  
• CSF volume: 5–10 mL
  
• Sample tube: Plain Universal container for CSF. Sample has limited stability – please contact Cytology.

Flow cytometry

• Department: Haematology
  
• Preferred tap: No preferred tap
• CSF volume: 2 mL (40 drops)
  
• Sample tube: Sample has limited stability – please contact Haematology
• Please note: This test would only be added onto a sample following discussion with a Consultant Haematologist. Please note, usually a fresh sample is required.

Glycine

• Department: Chemical Pathology
• Preferred tap: No preferred tap but sample must be very clean.
  
• CSF volume: 0.1 mL (5 drops)
  
• Sample tube: Plain Universal container for CSF and a lithium heparin tube for blood.

Lactate (rarely useful)

• Department: Chemical Pathology
  
• Preferred tap: Tap #2
• CSF volume: 0.25 mL(6 drops)
• Sample tube: Fluoride-oxalate tube or Plain Universal container sent immediately to the laboratory.

Please note: 1 mL of CSF is approximately equal to 25 drops from the Luer connector of the needle.

Container and form labelling

Label ALL bottles with:

• The tap number (1-4)
  
• Hospital number
  
• Surname
  
• Forename
  
• Date of birth
  

On the request form for Chemical Pathology please indicate:

• Clinical reason for the investigation
  
• The result of the CT scan
  
• Date of any previous lumbar puncture (if within the last month)
  
• The time and date of the onset of current symptoms/event
  
• The date and time of the current lumbar puncture
  

Further information

To learn more about CSF analysis, visit Lab Tests OnLine

Page last updated 10/12/2024