Head injury outcome prediction: a role for protein S-100B?
BACKGROUND
Prediction of the likely outcome of head injury from the outset would allow early rehabilitation to be targeted at those with most to gain. Clinical evaluation of a head injured patient may be confounded by intoxicants such as alcohol. Imaging modalities are insensitive (CT) or impractical (MR) for screening populations of such patients. A peripheral marker that reflected the extent of brain injury might offer an objective indication of likely adverse sequelae. This review evaluates the evidence for Protein S-100B as such a marker.


METHODS
A search of published literature revealed 18 studies designed to evaluate the relation between serum S-100B and measures of outcome after head injury.


RESULTS
A cut-off point of 2.5microg/L is related to dependent disability in those presenting with low conscious level, and may be a specific test for this. There appears to be a relation between initial serum S-100B concentration and measures of disability as well as post-concussion symptoms for those with seemingly mild injuries. There does not appear to be a relation between S-100B and measures of neuropsychological performance.


CONCLUSIONS
Patients with high levels of S-100B at initial assessment (>2.5microg/L) may represent a high risk group for disability after head trauma.
Townend
Will
W
Emergency Department, Hull Royal Infirmary, Anlaby Road, Hull HU3 2JZ, UK. William.Townend@hey.nhs.uk
Ingebrigtsen
Tor
T
D015415:Biomarkers / Q000097:blood; D001930:Brain Injuries / Q000097:blood* / Q000534:rehabilitation; D006259:Craniocerebral Trauma / Q000097:blood* / Q000534:rehabilitation; D004632:Emergency Medical Services; D005500:Follow-Up Studies; D015600:Glasgow Coma Scale; D006801:Humans; D017063:Outcome Assessment, Health Care / Q000379:methods*; D010865:Pilot Projects; D011237:Predictive Value of Tests; D009418:S100 Proteins / Q000097:blood*
D015415:Biomarkers; D009418:S100 Proteins