Protein S100b in differential diagnosis of brain concussion and superficial scalp injury in inebriated patients

Authors: J. Matek 1;  D. Vajtr 2;  Z. Krška 1;  D. Springer 3;  M. Filip 4;  T. Zima 3
Authors‘ workplace: 1. chirurgická klinika VFN 1. LF UK v Praze přednosta: Prof. MUDr. Z. Krška, CSc. 1;  Ústav soudního lékařství a toxikologie 1. LF UK a VFN v Praze, přednosta: Prof. MUDr. P. Strejc, DrSc. 2;  Ústav klinické biochemie a laboratorní diagnostiky 1. LF UK a VFN v Praze přednosta: Prof. MUDr. T. Zima, CSc. 3;  Oddělení neurochirurgie KNTB Zlín, primář: MUDr. M. Filip, PhD. 4
Published in: Rozhl. Chir., 2012, roč. 91, č. 10, s. 545-549.
Category: Original articles


Concussion cannot be differentiated from superficial scalp injury, especially in inebriated or uncooperative patients. This can have serious medical or forensic consequences. The aim of the study was to determine whether serum concentrations of S-100b in mild traumatic brain injury (MTBI) patients are significantly higher than those in patients with superficial scalp injury with scalp wound and alcohol intoxication.

Material and methods:
A total of 50 patients with head injury, 25 with mild concussion without scalp wound and alcohol intoxication, 25 superficial scalp injury patients with scalp wound and clinical signs of inebriety. Neurological status and cranial CT scan were evaluated 60–120 minutes after injury in all the 50 patients to exclude focal cerebral injury or skull fracture.

The serum levels of S-100b were significantly increased in patients with concussion (median 0.36 ± 0.15 μg/l ) in comparison with the group of patients with scalp injury and alcohol intoxication (median 0.09 ± 0.002 μg/l). All 50 patients had a normal cranial CT finding and neurological status. In all superficial scalp injury patients alcohol intoxication was confirmed (0.96 – 3.11š).

We proved significantly higher values of S-100b in patients with brain concussion. Diagnostically decisive value of S-100b concentration in the serum was set at 146 μg/l and higher (94% sensitivity and 100% specificity). Alcohol intoxication (up to 3.11 š) and scalp wound seem to have had no crucial impact on serum S-100b level.

Key words:
concussion – S-100b – superficial scalp injury – alcohol intoxication.


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