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Cerebrospinal Fluid (CSF)

Cerebrospinal fluid is a clear liquid that surrounds the brain and the spinal cord.

It has several functions:

  • Cushioning the brain and spinal cord
  • Acting as a shock absorber in the event of injury
  • Maintaining a stable pressure inside the skull
  • Reducing the weight of the brain. Because the brain is floating in the CSF, its weight is decreased from 1500 grams to less than 50 grams
  • Supply nutrients to the brain
  • Remove waste from the brain

Symptoms

The symptoms of a problem with the cerebrospinal fluid depend on the underlying cause. Many of the symptoms of problems with CSF are similar to symptoms of other conditions. Some possible symptoms include:

  • Fever
  • Seizures
  • Lethargy
  • Difficulty feeding
  • Vomiting
  • Sleeping more than normal
  • Floppy arms or legs
  • Rapid breathing or grunting
  • Pale, blotchy skin
  • Bright lights hurt eyes
  • Stiff neck

Causes

Newborns can have several conditions which present as problems with the cerebrospinal fluid. Some examples include:

  • Hydrocephalus
  • Intraventricular haemorrhage
  • Meningitis
  • Central nervous system infections because of HIV (HIV is often transmitted mother to child)
  • Other central nervous system infections

Reference Articles

Risk Factors

Some risk factors for problems with the cerebrospinal fluid include:

  • Being born premature
  • Low or very low birth weight babies
  • Being born to an HIV-positive mother whose HIV is not being treated

Diagnosis

Problems or infections of the cerebrospinal fluid are uncommon. Thus, it is likely that the doctor will request a blood sample and imaging first. Once doctors have determined that a problem with cerebrospinal fluid is the most likely cause of the baby’s symptoms, they will request a sample of CSF for analysis.

To get the sample, a lumbar puncture is performed. In this procedure, the baby is placed in a curled-up position and a member of the healthcare team holds them there. Then the skin along the lower spine is cleaned. A needle is then inserted between the vertebrae (bones in the spine) to collect a sample of the fluid. The procedure can take up to an hour.

Once the sample is collected, it is sent to the lab for analysis.

Treatment

Treatment depends on the cause of the CSF problem.

Possible treatments include:

  • Antibiotics for bacterial infections
  • Antifungals for fungal infections
  • Close monitoring and treatment of symptoms in viral infections
  • Medication for HIV if the infant is HIV positive
  • Medications to help stabilize any other symptoms the infant is experiencing
  • Surgery to remove excess cerebrospinal fluid trapped in the brain if hydrocephalus is the diagnosis

Complications

Complications of problems with the cerebrospinal fluid depend on the severity of the cause. Some possible complications include:

  • Developmental problems
  • Learning disabilities
  • Cerebral palsy
  • Hearing loss, either partial or complete
  • Vision loss, either partial or total blindness
  • Seizures
  • Problems with coordination and movement
  • Problems with balance
  • Behavioural problems
  • Kidney problems
  • Bone or joint pain
  • Coma
  • Death

Prevention

It is not always possible to prevent problems with the cerebrospinal fluid.

A pregnant woman can help her child be as healthy as possible by:

  • Attending all her pregnancy checkups
  • Taking her HIV medications as prescribed if she’s HIV positive
  • Avoiding drinking alcohol, smoking, and taking street drugs during pregnancy

The answer to treating this condition is early diagnosis in order to start immediate treatment.

 
 
 

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