Fatal secondary increase in serum S-100B protein after severe head injury. Report of three cases.
The S-100B protein is a small cytosolic protein that is found in astroglial or Schwann cells. It is highly specific for brain tissue and is increasingly being investigated as a diagnostic tool to assess the neurological damage after head injury, stroke, subarachnoid hemorrhage, and cardiopulmonary bypass. The authors report on three patients with severe head injury with otherwise normal cerebral perfusion pressure, SaO2, PaCO2, and controlled intracranial pressure (ICP), in whom a secondary excessive increase in serum S-100B was observed. In all cases, the S-100B increase was followed by an increase in ICP. All three patients died within 72 hours after the excessive increase in S-100B. These findings indicate that major secondary brain damage may occur at a cellular level without being identified by current neuromonitoring techniques.
Raabe
A
A
Department of Neurosurgery, Neurology and Neurosurgery Center, University of Frankfurt am Main, Germany. Raabe@workmail.com
Seifert
V
V
D000293:Adolescent; D000328:Adult; D002245:Carbon Dioxide / Q000097:blood; D002560:Cerebrovascular Circulation; D006259:Craniocerebral Trauma / Q000097:blood* / Q000150:complications / Q000503:physiopathology; D017809:Fatal Outcome; D006801:Humans; D019586:Intracranial Hypertension / Q000097:blood / Q000209:etiology / Q000503:physiopathology; D007427:Intracranial Pressure; D008297:Male; D008875:Middle Aged; D010100:Oxygen / Q000097:blood; D009418:S100 Proteins / Q000097:blood*
D009418:S100 Proteins; D002245:Carbon Dioxide; D010100:Oxygen