CSF collection

- Use sterile containers and clearly label specimens with number order collected.

- Take paired blood samples as necessary (see table below).

- Not all tests are appropriate on all patients - please be selective.

- Except for the fluoride oxalate for sample 2, please DO NOT use Vacuette® tubes for CSF as the additives can make them unsuitable for analysis.

 - Sample 1 and 3 should be sent to the Microbiology Department.


Sample 1


This is likely to be contaminated with blood. Please send to Microbiology as a reserve sample.

Sample 2


0.5 mL in fluoride oxalate tube. In general, fill to lower edge of label.

0.5 mL in fluoride oxalate for glucose, lactate (to Clinical Biochemistry).

Please use yellow forms for CSF biochemistry to ensure prompt handling in lab.


For Hurstwood Park Medical we have additional guidelines clarifying Biochemistry arrangements at PRH:

CSF Samples for Biochemistry – Guidelines for Hurstwood Park Medical

Download HWP CSF guidleines

 (revision 2, last reviewed 29.10.2016)


Sample 3


5 mL plain sample for Microbiology (microscopy, organism detection, culture)

Sample 4

3 mL in universal container. In general, fill to lower edge of label.

3 mL plain sample for Clinical Biochemistry (xanthochromia, protein, oligoclonal bands).

Samples for xanthochromia must be protected from the light - wrap in foil or place sample in a thick brown envelope outside the usual plastic specimen bag. Failure to do this may lead to sample degradation and false-negative results.

Samples must be delivered to Clinical Biochemistry immediately.

Do not send CSF for xanthochromia scan by pneumatic pod system.

Please use yellow forms for CSF biochemistry to ensure prompt handling in lab.



Sample 5 for Cytology (if required) For CSF cytology requirements click here.


Take paired blood samples


gold top tubeclotted blood if requesting xanthochromia or CSF oligoclonal bands,

grey top tubefluoride oxalate if requesting CSF glucose.


If the sample is suspected of containing high-risk pathogens such as vCJD or TB, then the request form MUST be clearly labelled so to allow the safe handling of the specimen by laboratory staff.