• Neurosurgery · Jun 2011

    Neuron-specific enolase, S100B, and glial fibrillary acidic protein levels as outcome predictors in patients with severe traumatic brain injury.

    • Ana Elisa Böhmer, Jean Pierre Oses, André Prato Schmidt, Cleiton Schweister Perón, Claudio Liss Krebs, Paulo Petry Oppitz, Thiago Torres D'Avila, Diogo Onofre Souza, Luis Valmor Portela, and Marco Antonio Stefani.
    • Department of Biochemistry, ICBS, Federal University of Rio Grande do Sul, Porto, Alegre, RS, Brazil.
    • Neurosurgery. 2011 Jun 1;68(6):1624-30; discussion 1630-1.

    BackgroundThe availability of markers able to provide an early insight related to prognostic and functional outcome of patients with traumatic brain injury (TBI) are limited.ObjectiveThe relationship of clinical outcome with CSF neuron-specific enolase (NSE), S100B and glial fibrillary acidic protein (GFAP) levels in patients with severe TBI was investigated.MethodsTwenty patients with severe TBI (7 days at unit care) and controls were studied. Patients were grouped according to the outcome: (1) nonsurvival (n=5): patients who died; (2) survival A (n=15): CSF sampled between 1st and 3rd day from patients who survived after hospital admission; and (3) survival B (n=7): CSF sampled between 4th and 7th day from patients who survived after hospital admission and were maintained with intraventricular catheter up to 7 days.ResultsUp to 3 days, S100B and NSE levels (ng/mL) were significantly elevated in the nonsurvival compared with survival A group (S100: 12.45 ± 5.46 vs 5.64 ± 3.36; NSE: 313.20 ± 45.51 vs 107.80 ± 112.10). GFAP levels did not differ between groups. In the survival B group S100B, GFAP, and NSE levels were still elevated compared with control (4.59 ± 2.19, 2.48 ± 2.55, and 89.80 ± 131.10, respectively). To compare S100B and NSE for the prediction of nonsurvival and survival patients we performed receiver operating characteristic curves. At admission, CSF NSE level predicts brain death more accurately than S100B.ConclusionEarly elevations (up to 3 days) of S100B and NSE secondary to severe TBI predict deterioration to brain death. However, this feature was more prominently associated with NSE than S100B.Copyright © 2011 by the Congress of Neurological Surgeons

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