title: Prolonged elevation of serum neuron-specific enolase in children after clinical diagnosis of brain death.
abstract: To elucidate the time course of neuronal cell death after the clinical criteria for brain death are met, the authors reviewed serial changes of serum neuron-specific enolase levels in 3 children (age range, 3-15 years) clinically diagnosed as brain dead due to cardiopulmonary arrest. All patients survived for more than 2 months after brain death. Children with brain death had higher peak neuron-specific enolase values (1069-2849 ng/mL) than did 3 control children (256-1800 ng/mL) who did not become brain dead but had poor neurological outcome (1 death, 2 vegetative state) after cardiopulmonary arrest. A major finding is that children with brain death showed persistent elevation of neuron-specific enolase at 4 weeks (>400 ng/mL) and 8 weeks (>50 ng/mL) after cardiopulmonary arrest, in comparison with 2 surviving patients without brain death (<50 ng/mL at 4 weeks). This prolonged elevation of neuron-specific enolase suggests that total brain necrosis might not be present at the time of clinical diagnosis of brain death.
authors.affiliation: Department of Pediatric Neurology, Osaka Medical Center and Research Institute for Maternal and Child Health, Osaka, Japan. yasuzuki@mch.pref.osaka.jp
authors.forename: Yasuhiro
authors.initials: Y
authors.lastname: Suzuki
authors.forename: Yukiko
authors.initials: Y
authors.lastname: Mogami
authors.forename: Yausihisa
authors.initials: Y
authors.lastname: Toribe
authors.forename: Keitaro
authors.initials: K
authors.lastname: Yamada
authors.forename: Keiko
authors.initials: K
authors.lastname: Yanagihara
authors.forename: Ikuko
authors.initials: I
authors.lastname: Hirata
authors.forename: Toshiyuki
authors.initials: T
authors.lastname: Mano
mesh_terms: D000293:Adolescent; D001926:Brain Death / Q000097:blood*; D002675:Child, Preschool; D005260:Female; D005500:Follow-Up Studies; D006323:Heart Arrest / Q000150:complications*; D006801:Humans; D007223:Infant; D008297:Male; D010751:Phosphopyruvate Hydratase / Q000097:blood*; D012189:Retrospective Studies
chemical_list: D010751:Phosphopyruvate Hydratase