Traumatic brain damage in minor head injury

Relation of serum S-100 protein measurements to magnetic resonance imaging and neurobehavioral outcome

Tor Ingebrigtsen, Knut Waterloo, Eva A. Jacobsen, Bodil Langbakk, Bertil Romner*

*Corresponding author for this work

Research output: Contribution to journalArticle

177 Citations (Scopus)

Abstract

OBJECTIVE: The present study was conducted to validate S-100 protein as a marker of brain damage after minor head injury. METHODS: We studied 50 patients with minor head injuries and Glasgow Coma Scale scores of 13 to 15 in whom computed tomographic scans of the brain revealed no abnormalities. Serum levels of S-100 protein were measured at admittance and hourly thereafter until 12 hours after injury. Magnetic resonance imaging and baseline neuropsychological examinations were performed within 48 hours, and neuropsychological follow-up was conducted at 3 months postinjury. RESULTS: Fourteen patients (28%) had detectable serum levels of S-100 protein (mean peak value, 0.4 μg/L [standard deviation, ± 0.3]). The S-100 protein levels were highest immediately after the trauma, and they declined each hour thereafter. At 6 hours postinjury, the serum level was below the detection limit (0.2 μg/L) in five (36%) of the patients with initially detectable levels. Magnetic resonance imaging revealed brain contusions in five patients, four of whom demonstrated detectable levels of S-100 protein in serum. The proportion of patients with detectable serum levels was significantly higher when magnetic resonance imaging revealed a brain contusion. In patients with detectable serum levels, we observed a trend toward impaired neuropsychological functioning on measures of attention, memory, and information processing speed. CONCLUSION: Determination of S-100 protein levels in serum provides a valid measure of the presence and severity of traumatic brain damage if performed within the first hours after minor head injury.

Original languageEnglish
Pages (from-to)468-476
Number of pages9
JournalNeurosurgery
Volume45
Issue number3
DOIs
Publication statusPublished - Sep 1999
Externally publishedYes

Keywords

  • Computed tomographic scan
  • Head injury
  • Magnetic resonance imaging
  • Neurobehavioral outcome
  • S-100 protein

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