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--- content:cerebrospinal_fluid [2020/02/02 11:34] – ↷ Links adapted because of a move operation icna
+++ content:cerebrospinal_fluid [2020/02/17 12:39] – [References] icna
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 ====== Cerebrospinal fluid (CSF) ======
+{{tag>labtests}}
 The cerebrospinal fluid (CSF) is formed by the choroid plexuses within the ventricles, passes into the subarachnoid space around the spinal cord and finally over the surface of the brain, to be absorbed in the arachnoid villi in the sagittal sinus. The composition of the CSF changes during circulation from its creation to its final absorption. The CSF protein is lowest in the lateral ventricles, intermediate in the lumbar subarachnoid space, and highest in the subarachnoid spaces over the surface of the cerebral hemispheres where it is sometimes sampled in mistake for subdural fluid. Except when there is obstruction to the flow of CSF from the ventricular system or potential downward herniation of the brain, CSF is obtained by a lumbar puncture. A blood sample  must always be taken at the same time as lumbar puncture (preferably immediately before) to allow proper interpretation of CSF findings.
 ===== Appearance =====
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 Although it has been suggested that in adults - where multiple sclerosis is a predominant condition - it is only necessary to request IEF for OCB, in children it is wise to request both quantitative (CSF:serum IgG index) and qualitative (isoelectric focusing for OCB) measures to determine whether there is local CSF IgG synthesis.
 ===== Asialotransferrin =====
-The proportion of asialotransferrin ([[:desialotransferrin]], tau protein, t protein) to total transferrin may be measured simply, quickly and cheaply by 2D gel electrophoresis. Normally asialotransferrin forms more than 8% of CSF transferrin, but in [[:elf2b-relaled_disorders]] ([[:vanishing_white_matter_disease]] and several other phenotypes) it is below 8%. Although this test has not yet been validated in infancy, from toddlerhood onwards it has a high degree of sensitivity and specificity to predict mutations in the genes responsible for one of the five subunits of [[:elf2b]]. It may be a first-line investigation once a leukoencephalopathy has been detected on MRI/MRS.
+The proportion of asialotransferrin ([[:desialotransferrin]], tau protein, t protein) to total transferrin may be measured simply, quickly and cheaply by 2D gel electrophoresis. Normally asialotransferrin forms more than 8% of CSF transferrin, but in [[:elf2b-relaled_disorders|elf2b related disorders]] ([[:vanishing_white_matter_disease|vanishing white matter disease]] and several other phenotypes) it is below 8%. Although this test has not yet been validated in infancy, from toddlerhood onwards it has a high degree of sensitivity and specificity to predict mutations in the genes responsible for one of the five subunits of [[:elf2b]]. It may be a first-line investigation once a leukoencephalopathy has been detected on MRI/MRS.
 ===== Myelin basic protein =====
-This component of myelin may be found in increased quantities at the time of acute demyelination (as in [[:acute_disseminating_encephalomyelitis]]), but data on sensitivity and specificity are limited.
+This component of myelin may be found in increased quantities at the time of acute demyelination (as in [[:acute_disseminating_encephalomyelitis|acute disseminating encephalomyelitis]]), but data on sensitivity and specificity are limited.
 ===== Cytokines =====