Document Detail


Diagnostic value of S100B and neuron-specific enolase in mild pediatric traumatic brain injury.
MedLine Citation:
PMID:  19795965     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECT: During recent years, several biomarkers have been introduced for use in the diagnosis of traumatic brain injury (TBI). The primary objective of this investigation was to determine if S100B (or S100 calcium-binding protein B) and neuron-specific enolase (NSE) serum concentrations can effectively be used to discriminate between symptomatic and asymptomatic children with minor head trauma. METHODS: The authors conducted a prospective clinical study that involved patients age 6 months to 15 years who had sustained minor head trauma. Children with concomitant extracranial injuries were excluded. Blood samples were obtained within 6 hours of injury to measure S100B and NSE levels in serum. The authors defined 2 diagnostic groups: a mild TBI group (patients with Glasgow Coma Scale [GCS] scores of 13-15) in whom there were clinical signs of concussion (short loss of consciousness, amnesia, nausea, vomiting, somnolence, headache, dizziness, or impaired vision) and a head contusion group (patients with a GCS score of 15) in whom symptoms were absent. Both S100B and NSE concentrations were compared between the 2 groups. Secondary end points were defined as follows: correlation of S100B/NSE and a) the presence of scalp lacerations, b) GCS score, c) age, and d) correlation between S100B and NSE. RESULTS: One hundred forty-eight patients were enrolled (53 in the contusion group, 95 in the mild TBI group). After adjusting for differences in age and time of injury to blood sample withdrawal, there was no significant difference in S100B or NSE between patients in the 2 groups. Scalp lacerations and GCS score had no affect on posttraumatic S100B or NSE concentrations. The correlation between S100B and NSE was significant. Both markers showed a significant negative correlation with age. CONCLUSIONS: The authors demonstrated that S100B and NSE do not discriminate between symptomatic and asymptomatic children with minor head injury. There seem to be limitations in marker sensitivity when investigating pediatric patients with mild TBI.
Authors:
Christian Geyer; Anett Ulrich; Gerd Gräfe; Barbara Stach; Holger Till
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Journal of neurosurgery. Pediatrics     Volume:  4     ISSN:  1933-0715     ISO Abbreviation:  -     Publication Date:  2009 Oct 
Date Detail:
Created Date:  2009-10-02     Completed Date:  2009-10-20     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101463759     Medline TA:  J Neurosurg Pediatr     Country:  United States    
Other Details:
Languages:  eng     Pagination:  339-44     Citation Subset:  IM    
Affiliation:
Department of Pediatric Surgery, University of Leipzig, Germany. christian.geyer@medizin.uni-leipzig.de
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Biological Markers / blood
Brain Concussion / blood,  diagnosis*
Brain Injuries / blood,  diagnosis*
Child
Child, Preschool
Female
Head Injuries, Closed / blood,  diagnosis*
Humans
Infant
Male
Nerve Growth Factors / blood*
Phosphopyruvate Hydratase / blood*
Predictive Value of Tests
Prospective Studies
Reference Values
S100 Proteins / blood*
Chemical
Reg. No./Substance:
0/Biological Markers; 0/Nerve Growth Factors; 0/S-100 calcium-binding protein beta subunit; 0/S100 Proteins; EC 4.2.1.11/Phosphopyruvate Hydratase

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