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Bilirubin, Cerebrospinal Fluid — Qualitative

Published: August 9, 2026Updated: August 16, 2026

A cerebrospinal fluid test that checks for the presence of bilirubin, a yellow pigment produced during the breakdown of blood.

Quick summary

["Detecting bilirubin in cerebrospinal fluid may help evaluate prior bleeding or blood breakdown within the central nervous system."]

Medically reviewed by WellAlly Editorial TeamLast reviewed August 16, 2026Editorial policy

Key facts at a glance

LOINC
53415-6
Short code
Bilirub CSF Ql
Synonyms
Bilirub CSF Ql
Category
liver
Sample
csf
Container
Sterile tube
Units
N/A
Fasting
false
Population
adult
Sex
all
Age range
18–65 years
Specimen volume
1-2 mL
Stability
Immediate analysis required, Refrigerated: 1h
Hemolysis max
200
TAT
4–24 hours
Order
routine

What is this test?

This test examines cerebrospinal fluid, the clear fluid surrounding the brain and spinal cord, for bilirubin. Bilirubin is a yellow pigment that forms when hemoglobin breaks down.

Why might I need this test?

It may be used as part of an evaluation for bleeding within the brain or spinal area, particularly when there has been blood in the cerebrospinal fluid. It can sometimes help distinguish recent bleeding from older blood or blood breakdown.

How is the test performed?

Cerebrospinal fluid is usually collected through a lumbar puncture, also called a spinal tap. A laboratory then tests the fluid for the presence of bilirubin and reports the result as detected or not detected.

How do I prepare for the test?

No specific food, drink, or medication instructions are usually required for a spinal tap. Tell the clinician if you have a bleeding disorder, take blood thinners, or have a history of significant spinal or back problems.

Clinical interpretation

How abnormal results are interpreted and what conditions they suggest.

Bilirubin detected in cerebrospinal fluid may reflect blood breakdown from bleeding within the central nervous system or contamination during the spinal tap. The finding is interpreted with the fluid’s color, other laboratory results, imaging, and clinical history. A result alone does not establish the cause or location of bleeding.

Short name

CSF bilirubin (qualitative)

Frequently asked questions

Does a positive result mean I am actively bleeding?
Not necessarily. Bilirubin can remain detectable after older blood has broken down, and blood entering the fluid during collection can also affect the result.
Is a lumbar puncture painful?
Most people feel pressure or brief discomfort during the procedure. Local anesthetic is generally used to numb the area, and post-procedure monitoring is common.
What other tests may be used with CSF bilirubin?
Clinicians may also review cerebrospinal fluid glucose, protein, cell count, red blood cell count, and imaging findings. These results together provide more context than the bilirubin test alone.
  1. 1
    MedlinePlus — Laboratory TestsSource
  2. 2
    Lab Tests OnlineSource
  3. 3
    Mayo Clinic — Tests & ProceduresSource

Click any link to access the full source. PubMed Central (PMC) links provide free full-text access.

This information is for educational purposes only and is not a substitute for professional medical advice, diagnosis, or treatment.

Medical Disclaimer

This content is for general informational and educational purposes only and is not a substitute for professional medical advice, diagnosis, or treatment. Always seek the guidance of a qualified healthcare provider with any questions you have about a medical condition, and never disregard professional medical advice or delay seeking it because of something you read here.

If you think you may have a medical emergency, call your local emergency number or go to the nearest emergency department immediately.

Medically reviewed by WellAlly Editorial Team Last reviewed August 16, 2026. · Read our editorial policy