title: Early prognostication in acute brain damage: where is the evidence?
abstract: OBJECTIVE
  Early prognostication in acute brain damage remains a challenge in the realm of critical care. There remains controversy over the most optimal methods that can be utilized to predict outcome. The utility of recently reported prognostic biomarkers and clinical methods will be reviewed.
  
  
  RESULTS
  Recent guidelines touch upon prognostication techniques as part of management recommendations. In addition to novel laboratory values, there have been few reports on the use of clinical parameters, diagnostic imaging techniques, and electrophysiological techniques to assist in prognostication.
  
  
  CONCLUSIONS
  Although encouraging, newer markers are not capable of providing accurate estimates on outcomes in acute injuries of the central nervous system. Traditional markers of prognostication may not be applicable in the light of newer and effective therapies (i.e. hypothermia). Substantial research in the field of outcome determination is in progress, but these studies need to be interpreted with caution.
authors: Division of Neurosciences Critical Care Medicine, Department of Neurology and Neurosurgery, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
authors: Atul A
authors: AA
authors: Kalanuria
authors: Romergryko G
authors: RG
authors: Geocadin
mesh_terms: D015415:Biomarkers / Q000097:blood; D001925:Brain Damage, Chronic / Q000097:blood* / Q000401:mortality / Q000503:physiopathology; D001930:Brain Injuries / Q000097:blood* / Q000401:mortality / Q000503:physiopathology; D002097:C-Reactive Protein / Q000378:metabolism; D003422:Critical Care; D003657:Decision Making; D004594:Electrophysiology / Q000379:methods*; D019317:Evidence-Based Medicine; D005073:Evoked Potentials, Somatosensory; D005190:Family; D005260:Female; D006323:Heart Arrest / Q000097:blood* / Q000401:mortality / Q000503:physiopathology; D006801:Humans; D007036:Hypothermia, Induced; D008297:Male; D009043:Motor Activity; D009363:Neoplasm Proteins / Q000097:blood; D009414:Nerve Growth Factors / Q000097:blood; D059906:Neuroimaging / Q000379:methods*; D017410:Practice Guidelines as Topic; D011379:Prognosis; D016414:Resuscitation Orders; D064568:S100 Calcium Binding Protein beta Subunit; D009418:S100 Proteins / Q000097:blood; D000683:Serum Amyloid P-Component / Q000378:metabolism; D000099153:Pentraxins
chemical_list: D015415:Biomarkers; D002097:C-Reactive Protein; D009363:Neoplasm Proteins; D009414:Nerve Growth Factors; D064568:S100 Calcium Binding Protein beta Subunit; D009418:S100 Proteins; D000683:Serum Amyloid P-Component; D000099153:Pentraxins; C460840:RCBTB2 protein, human