Skip to content

Bilirubin, Cerebrospinal Fluid

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

Measures bilirubin in cerebrospinal fluid to help assess blood breakdown products, liver-related abnormalities, or possible bleeding within the nervous system.

Quick summary

["This test measures a yellow liver pigment in spinal fluid and is interpreted alongside the rest of the cerebrospinal fluid panel."]

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

Key facts at a glance

LOINC
109424-2
Short code
Bilirub Msmt CSF
Synonyms
Bilirub Msmt CSF
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?

Cerebrospinal fluid, or CSF, surrounds the brain and spinal cord. This test measures bilirubin, a yellow pigment produced when the body breaks down a substance called heme, which is found in red blood cells.

Why might I need this test?

A clinician may order this test as part of a CSF evaluation for neurologic symptoms, suspected bleeding, or inflammation. It may also help explain an elevated bilirubin result elsewhere in the body, including jaundice.

How is the test performed?

CSF is usually collected through a lumbar puncture, commonly called a spinal tap. The laboratory then measures bilirubin in the fluid, and the result is interpreted with other CSF findings, symptoms, and blood test results.

How do I prepare for the test?

There is usually no special preparation for the bilirubin measurement itself. If a lumbar puncture is planned, follow your clinician's instructions, tell them about blood-thinning medicines or bleeding problems, and ask how you should manage any medicines before the procedure.

Clinical interpretation

How abnormal results are interpreted and what conditions they suggest.

An elevated CSF bilirubin level may occur when blood or blood-breakdown products are present in the CSF, including after bleeding within the head or spine. It can also reflect high blood bilirubin caused by liver or bile-duct disease, and it is not specific to one condition on its own. Your clinician will interpret this result together with the rest of the CSF panel and your medical history.

Short name

CSF Bilirubin

Frequently asked questions

Is a lumbar puncture required for this test?
The bilirubin test requires a cerebrospinal fluid sample. A lumbar puncture is the usual way to obtain it, although an existing CSF sample may sometimes be used.
Does an elevated result always mean there is bleeding in the brain?
No. Elevated CSF bilirubin can have several causes, including blood breakdown, bleeding, or high blood bilirubin from liver disease. Other test results and clinical findings are needed to determine the cause.
Do I need to fast before this test?
Fasting is generally not required for measuring bilirubin in CSF. Follow the specific instructions given for the lumbar puncture and tell your clinician about medicines, bleeding disorders, allergies, or prior imaging involving the nervous system.
  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