Evaluation of Relevance in Concussion and Damage of Health by Monitoring of Neuron Specific Enolase and S-100b Protein


Authors: D. Vajtr 1,2;  R. Průša 2;  J. Kukačka 2;  L. Houšťava 3;  F. Šámal 3;  M. Pelichovská 4;  P. Strejc 1;  P. Toupalík 5
Authors‘ workplace: Ústav soudního lékařství a toxikologie UK 1. LF a VFN, Praha 1;  Ústav klinické biochemie a patobiochemie UK 2. LF a FN Motol, Praha 2;  Klinika neurochirurgie UK 3. LF a FN Královské Vinohrady, Praha 3;  Klinika anesteziologie a resuscitace UK 2. LF a FN Motol, Praha 4;  Ústav soudního lékařství 2. LF UK, Praha 5
Published in: Soud Lék., 52, 2007, No. 3, p. 43-46

Overview

Introduction:
Proteins released to the circulation from affected glial (neuron specific enolasis, NSE) or ganglial cells (S-100b protein) during traumatic brain injury might be used in diagnosis of traumatic brain injury in cases with negative finding on computer tomography scan (concussion) or in patients where the serious clinical status does not corresponde with mild changes on CT scan (diffuse axonal injury, DAI). Classification of DAI according Gennarelli considered the concussion as lower degree of DAI.

Materials and method:
15 patients were divided into group I of mild conccussion (n=3) with 1-day duration of hospitalisation, group II of serious concussion (n=4) with more days duration of hospitalisation with negative findings on CT scan and group III of patients with diagnosis of DAI (n=8). Blood samples were investigated by immunoanalysis for NSE and protein S-100b (Elecsys 2010, Roche).

Results:
Values of NSE (16.30 ± 2.33 vs. 110.48 ± 34.99 vs. 24.07 ± 6.29 μg/l), and protein S-100b (0.207 ± 0.03 vs. 0.945 ± 0.69 vs. 0.736 ± 0.36 μg/l) overdrow the reference value in cases of group I, II, and III. We discuss the biomechanics of trauma and the blood brain barrier damage in comparison with values of NSE and S-100b protein.

Conclussion:
We proved the significantly higher values of the NSE in group of serious concussion compared to group of DAI. We demonstrated that concussions in some cases lead to serious damage of health.

Key words:
concussion – diffuse axonal injury - neuron specific enolasis – S-100b protein – damage of health


Labels
Anatomical pathology Forensic medical examiner Toxicology
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