Cerebrospinal fluid cell count following spinal cord injury

Cerebrospinal fluid (CSF) changes after spinal cord injury (SCI) were evaulated by retrospective analysis of all patients admitted to the Acute Spinal Cord Injury Unit (ASCIU) at University Hospital, Shaughnessy Site in Vancouver, British Columbia. A total of 1,917 admissions occurred during the 10-year study period with 1,151 due to acute trauma. The charts of all patients with SCI due to trauma were reviewed to identify patients in whom a CSF puncture was performed for any reason. Traumatic SCI is associated with elevations in the corrected white blood cell count (cWBC) that we believe reflect an inflammatory response to injury. The elevation in cWBC is greatest in the first week after injury. Elevations in cWBC more than 1 week after injury do occur but are uncommon. The white cell differential count consists primarily of lymphocytes and polymorphonucleocytes. Three weeks after injury cell counts should be normal. Protein levels are elevated after trauma and should not be used to assess the presence of infection. LP should be part of the septic workup of SCI patients just as it would be for any other population if meningitis is a consideration.