Thomson C E, Kornegay J N, Stevens J B
Department of Companion Animal and Special Species Medicine, College of Veterinary Medicine, North Carolina State University, Raleigh 27606.
J Am Vet Med Assoc. 1990 Jun 1;196(11):1841-4.
Data were obtained from 158 CSF samples from 145 dogs with focal, noninfectious/noninflammatory neurologic disease. The effect of lesion location and the duration and severity of clinical signs were studied. One hundred and twenty-five samples were obtained from the cerebellomedullary cistern (CMC), and 33 were obtained from the lumbar cistern (LC). Intracranial and cervical disease affected the CSF from the CMC more often than did thoracolumbar disease. However, lumbar CSF was more frequently affected by disease anywhere along the neuraxis. For compressive spinal cord disease, the protein concentration at both cisterns was more often high in acute, clinically severe lesions. Intracranial lesions consistently caused abnormalities in CSF from both the CMC (7 of 7; 100%) and LC (2 of 2; 100%). Abnormalities were identified in 16 of 38 (42%) and 5 of 7 (71%) CMC and LC samples, respectively, in dogs with cervical disease. In dogs with thoracolumbar lesions, only 22 of 80 (27.5%) CMC samples were abnormal, compared with 21 of 24 (87.5%) LC samples. These findings suggest that CSF collected cranial to the lesion may be normal or only mildly altered by focal neurologic disease. Fluid obtained caudal to the lesion presumably is more substantially altered because of the predominant caudal flow of CSF. To maximize the yield of diagnostic information from CSF analysis, the fluid should preferably be obtained caudad to the disease site; however, because of problems associated with lumbar puncture, we suggest that CSF from the CMC also be obtained.
数据来自145只患有局灶性、非感染性/非炎性神经疾病的犬的158份脑脊液样本。研究了病变位置以及临床症状的持续时间和严重程度的影响。125份样本取自小脑延髓池（CMC），33份取自腰池（LC）。与胸腰椎疾病相比，颅内和颈部疾病更常影响来自CMC的脑脊液。然而，腰段脑脊液更频繁地受到神经轴任何部位疾病的影响。对于压迫性脊髓疾病，在急性、临床严重病变中，两个池的蛋白质浓度更常升高。颅内病变始终导致来自CMC（7/7；100%）和LC（2/2；100%）的脑脊液异常。在患有颈部疾病的犬中，分别在38份CMC样本中的16份（42%）和7份LC样本中的5份（71%）中发现异常。在患有胸腰椎病变的犬中，80份CMC样本中只有22份（27.5%）异常，而24份LC样本中有21份（87.5%）异常。这些发现表明，在病变上方采集的脑脊液可能正常或仅受到局灶性神经疾病的轻微改变。由于脑脊液主要向尾端流动，在病变下方获取的液体可能会有更明显的改变。为了最大限度地从脑脊液分析中获得诊断信息，最好在疾病部位下方获取液体；然而，由于与腰椎穿刺相关的问题，我们建议也获取来自CMC的脑脊液。
