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Collection of
Cerebral Spinal Fluid |
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Spinal needles for use in small animals
are available in 20 to 22 gauge and 1- 1/2 to 3- 1/2 inches in length. All spinal needles
have a stylet. |
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Look at the tip of
the needle. The bevel of the needle is shorter than the bevel of a
hypodermic needle. Spinal fluid is obtained from the subarachnoid space which
is a shallow space. If you use a needle with a long bevel, part of the opening into the
lumen of the needle may be outside the subarchnoid space. |
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First method:
The
site of CSF collection from the cisterna magna (a) is between the occipital crest (b) and
the most prominent points of the wings of the atlas (c). Although some textbooks recommend
insertion of the needle at the halfway point between these two landmarks, I find one tends
to be just anterior to the cisterna at the halfway point. Instead, I divide this distance
into thirds and make the puncture 2/3 of the way back from the occipital crest.
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Second method: Instead of the above
mentioned landmarks, use your fingertips to trace the wings of the atlas to their most
anterior margins. Palpate the occipital crest to define the midline. The cisterna is
located on the midline, at the level of the anterior aspect of the wings of the atlas. |
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The animal should be placed in lateral
recumbency with the nose flexed and ears pulled ventrally. The dorsum should be close to
the edge of the table. |

The puncture site is clipped of hair and
aseptically prepared for the procedure. The person performing the procedure is wearing
sterile gloves. The puncture is made on the midline. The needle is advanced slowly and
carefully, removing the stylet at intervals to check for the presence of spinal fluid in
the needle. If you are unsure if there is fluid in the needle, wipe the stylet across your
sterile glove and look for a streak of fluid. If the needle is dry, replace the stylet and
continue to slowly advance the needle. If the needle hits bone, and fluid has not been
obtained, angle the needle cranial or caudel (which direction depends upon initial point
of needle entry) and try to "walk" the needle off the bone into the cisterna. If
you are unsure whether to "walk" cranial or caudel, remove the needle, revaluate
landmarks and try again. If you obtain blood, let a few drops flow. If the fluid remains
heavily bloody, remove the needle. You entered a lateral venous sinus. Try again. If the
fluid becomes clear, collect it for analysis.
Although a manometer can be applied to the
needle to measure the opening pressure of CSF, I find that application of the manometer
often results in loss of the puncture. Therefore I do not routinely measure CSF pressures.
You can collect CSF using a small (3ml) syringe or by gravity into a sterile container. If
you use a syringe to collect CSF, do not attach the syringe to the hub of the needle.
Rather use the syringe to aspirate drops of CSF that form in the hub of the spinal needle.
Continue to hold the hub of the spinal needle as spinal fluid is collected so the tip of
the needle is not dislodged from the subarachnoid space. Compression of the jugular veins
will increase the rate of flow of CSF. The sample for cytology and fluid analysis is
placed into an EDTA tube. Samples for bacterial or viral culture are not
anticoagulated.
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Revised
June 19, 2004
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