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Abstract

In cerebrospinal fluid, the concentration oflactate is elevated above the upper limit of the normal range (> 2.0mmol/l) in a great variety of inflammatory, vascular, neoplastic, and metabolic diseases of the brain and the meninges, respectively. The determination oflactate can help to differentiate 1. untreated or partially treated bacterial meningitis from viral meningitis. 2. transient ischemic attacks from generalized epileptic seizures when anamnestic or clinical information is not available and 3. artificial bloody contamination of the CSF due to lumbar puncture from true intracerebral or subarachnoidal hemorrhage. Repeated evaluations of the lactate concentration allow to control the effectiveness of therapy. In vascular and traumatic brain disease and in intoxications as well the lactate concentration has prognostic significance.