Why protein level increase in spinal cord fluid?
Answers
Explanation:
Learn more about Protein Cerebrospinal Fluid Level
Cerebrovascular Disorders
Matthew Koenig, Eric M. Aldrich, in Cerebrospinal Fluid in Clinical Practice, 2009
Protein concentration
Elevated CSF protein concentration is common after ischemic stroke, most likely due to disruption of the blood–brain barrier along with some component of intrathecal antibody synthesis. Strokes occurring near the ventricular surface have been speculated to cause greater CSF protein elevation, but this has never been clearly demonstrated. Carasso et al. reported CSF protein concentrations in 16 patients with ischemic strokes who underwent LP within 72 h of symptom onset.10 Using an upper limit of normal of 45 mg/dl, 44% of patients had elevated CSF protein levels, with a maximum concentration of 104 mg/dl.10 Five of these patients, however, had diabetes, which often itself causes elevated CSF protein levels due to radicular demyelination. In another series of 161 patients with ischemic stroke who underwent LP a mean of 2.5 days after symptom onset, the mean CSF protein was 69 ± 40 mg/dl, with a range of 20–470 mg/dl.8 The CSF protein concentration was greater in a series of 21 patients with hemorrhagic conversion after ischemic stroke, with a mean of 114 ± 29 mg/dl and a range of 40–560 mg/dl.8 The time course for normalization of CSF protein levels after stroke has not been delineated, but most authors report normal values 1 month after the ictus.
CSF protein concentrations have also been correlated with stroke size and prognosis. Suzuki et al. reported a series of 57 stroke patients who underwent LP within 10 days of symptom onset (mean, 5.7 days). The mean CSF protein was 50.4 ± 23.3 mg/dl (range, 14–133 mg/dl), with a good correlation between higher protein concentration and larger stroke volume on brain CT.11 Another group compared CSF protein concentrations in 42 patients with acute ischemic stroke who underwent LP within 7 days, and six patients with subacute or chronic strokes who underwent LP more than 30 days after their event.12 The median CSF protein level for acute stroke patients was 46.7 mg/dl, with a range of 29.4–219 mg/dl, while the protein concentrations were normal in all 6 patients with remote events.12 In 24 patients who underwent serial LPs, protein concentrations decreased from a median of 51.7 mg/dl on the first day to 46.4 mg/dl on day 5.12 Here, elevated CSF protein concentration was correlated with a greater risk of death or severe disability. Conversely, another study of 312 stroke patients who underwent LP within 7 days showed elevated CSF protein levels in half of patients, but protein concentration did not correlate with stroke severity.13
Neuro-Oncology
Matthias Preusser, Johannes A. Hainfellner, in Handbook of Clinical Neurology, 2012
CSF protein and glucose concentration
High CSF protein concentration has been reported to be significantly and independently associated with an unfavorable outcome in patients with PCNSL (Ferreri et al., 2003). In this study, a prognostic score including CSF protein concentration, as well as patient age, performance status, serum lactate dehydrogenase (LDH) level, and involvement of deep structures of the brain has been proposed for distinguishing different risk groups in PCNSL. However, CSF protein concentration failed to correlate with meningeal involvement in a series of 116 immunocompetent patients with PCNSL (Fischer et al., 2006).
CSF glucose levels are often low relative to serum glucose levels in patients with PCNSL.
Bacterial meningitis leads to a more permeable blood brain barrier (due to increased inflammation). Protein leaks into the subarachnoid space from the blood, resulting in markedly increased CSF protein levels.