How is CSF transported?
The CSF flows through the ventricles into the subarachnoid space via the foramina of Luschka and of Magendie and circulates over the outer surfaces of the brain and spinal cord. Parenchymal interstitial fluid is actively secreted by the capillary endothelial cells.
How does CSF leak from ear?
CSF otorrhea occurs only if a perforation in the eardrum or a defect in the external ear canal is present. This is often the case when the leakage results from trauma or previous ear surgery. However, in the absence of such a defect, the fluid flows down the eustachian tube and manifests as a clear rhinorrhea.
What are the sites of cerebrospinal fluid aspiration?
CSF can be collected from two different sites, the cerebellomedullary cistern, located at the back of the head and the lumbar cistern, located at the lower part of the spinal column, near the pelvis. CSF collection requires a general anesthetic.
What is the order of CSF flow?
Normal route of CSF from production to clearance is the following: From the choroid plexus, the CSF flows to the lateral ventricle, then to the interventricular foramen of Monro, the third ventricle, the cerebral aqueduct of Sylvius, the fourth ventricle, the two lateral foramina of Luschka and one medial foramen of …
What should I send my CSF for?
Why are four tubes of cerebrospinal fluid (CSF) sample drawn in suspected meningitis and where is each sent?
- Tube 1 – Send to the chemistry laboratory for glucose and protein.
- Tube 2 – Send to the hematology laboratory for a cell count with differential.
- Tube 3 – Send to the microbiology and immunology laboratory.
What is the Halo test for CSF?
A “halo” or “ring” sign, occurs when cerebrospinal fluid (CSF) mixes with blood on an absorbent surface. The blood forms a spot in the center and a lightly stained ring forms a halo around it. The halo sign is reliable for detecting CSF but not exclusive.
How do I confirm my CSF in Otorrhea?
Imaging Studies
- Localization of an otogenic spinal fluid leakage is usually accomplished using imaging studies.
- Obtain a high-resolution CT scan with axial and coronal sections. Unless an otologic source is certain, the scan should cover all 3 cranial fossae.
- MRI may be helpful in pinpointing the site of a leak.
How do you preserve a CSF sample?
Use a sterile syringe and needle to inoculate 0.5-1.0 ml of CSF into the T-I medium. The remaining CSF should be kept in the collection tube. It should not be refrigerated, but should be maintained at room temperature (20-25°C) before Gram staining and other tests.
How is a CSF collected?
Your cerebrospinal fluid will be collected through a procedure called a spinal tap, also known as a lumbar puncture. A spinal tap is usually done in a hospital. During the procedure: You will lie on your side or sit on an exam table.
What does it mean to have CSF otorrhea?
CSF otorrhea is defined as leakage of cerebrospinal fluid (CSF) from the subarachnoid space into the middle ear cavity or mastoid air cells (cf. CSF rhinorrhea) There are a number of underlying causes, and thus no specific demographic is affected.
Where does CSF leak in the middle ear?
CSF otorrhea is defined as leakage of cerebrospinal fluid (CSF) from the subarachnoid space into the middle ear cavity or mastoid air cells (cf. Epidemiology. There are a number of underlying causes, and thus no specific demographic is affected.
When does iatrogenic CSF otorrhea occur after surgery?
Iatrogenic CSF otorrhea may occur immediately after surgery or may be delayed for days or years.
What should I do if I have otorrhea?
Some cases of otorrhea are due to water contamination; others are the result of AOM. Some cases also involve an inflammatory reaction to the tube itself. Treatment is the same: a topical polymicrobial-steroid suspension with or without an oral antibiotic, along with aural hygiene in the office.