Nonefficacy of routine removal of CSF during neurodiagnostic procedures

The charts of 750 patients were reviewed to determine the value of routinely removing cerebrospinal fluid at the time of myelography and cisternography for chemical and cytologic examination. In most patients cerebrospinal fluid findings were normal. In the few abnormal studies, the findings were often uninformative, superfluous, or insufficient for appropriate diagnosis. In no instance did routine analysis of cerebrospinal fluid uncover occult disease. Routine removal of cerebrospinal fluid for analysis in radiologic spinal taps seems to be inappropriate, and removal should be dictated by the clinical context in which the procedure is performed.