Likvoranalyse

Likvoranalyse, also known as cerebrospinal fluid (CSF) analysis, is a diagnostic procedure used to evaluate the composition of the fluid that surrounds the brain and spinal cord. The test involves a lumbar puncture, in which a needle is inserted into the lower part of the spinal canal to withdraw a small volume of CSF for laboratory examination. The procedure is performed under sterile conditions, often with the patient lying on their side or sitting, and is guided by anatomical landmarks or imaging when necessary.

The analysis provides information about the central nervous system’s biochemical, microbiological, and cellular status. Routine parameters include cell count and differential, protein concentration, glucose level, and the presence of oligoclonal bands, which may indicate intrathecal immunoglobulin synthesis. In addition, the fluid may be examined for bacterial cultures, viral PCR, fungal stains, and other pathogens, as well as for markers of inflammatory or neoplastic disease.

Interpretation of CSF results depends on the clinical context. Normal CSF typically contains 0–5 white blood cells per microliter, a protein concentration less than 45 mg/dL, and a glucose level that matches about two-thirds of the simultaneous serum glucose. Elevated protein, low glucose, or pleocytosis can suggest meningitis, encephalitis, autoimmune disorders, or metastatic disease. The presence of oligoclonal IgG bands is commonly associated with multiple sclerosis.

Contraindications to lumbar puncture include signs of increased intracranial pressure, coagulopathy, severe infection at the puncture site, or deformities that impede safe needle placement. When performed with proper technique and in appropriate clinical scenarios, likvoranalyse remains a cornerstone for diagnosing and monitoring a wide range of neurological conditions.