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Original Paper

S100B Is Not a Reliable Prognostic Index in Paediatric TBI

Piazza O.a · Storti M.P.a · Cotena S.b · Stoppa F.b · Perrotta D.b · Esposito G.c · Pirozzi N.b · Tufano R.a

Author affiliations

aDepartment of Anaesthesia and Intensive Care, University of Naples ‘Federico II’, and bEmergency Department, ‘Bambino Gesù’ Children’s Hospital, Rome, and cDepartment of Clinical Pathology, IRCCS ‘G. Pascale’, Naples, Italy

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Pediatr Neurosurg 2007;43:258–264

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Article / Publication Details

First-Page Preview
Abstract of Original Paper

Received: November 16, 2005
Accepted: September 19, 2006
Published online: July 12, 2007
Issue release date: July 2007

Number of Print Pages: 7
Number of Figures: 0
Number of Tables: 3

ISSN: 1016-2291 (Print)
eISSN: 1423-0305 (Online)

For additional information: https://www.karger.com/PNE

Abstract

Background: As far as paediatric traumatic brain injury is concerned, it is difficult to quantify the extent of the primary insult, to monitor secondary changes and to predict neurological outcomes by means of the currently used diagnostic tools: physical examination, Glasgow Coma Scale (GCS) score and computed tomography. For this reason, several papers focused on the use of biochemical markers (S100B, neuron-specific enolase) to detect and define the severity of brain damage and predict outcome after traumatic head injury or cardiac arrest. Objective: The aim of this paper is measuring the range of S100B serum concentrations in children affected by traumatic brain injury and describing the possible roles of this protein in the reaction to trauma. Methods: Fifteen children aged 1–15 years were included in the study. Traumatic brain injury severity was defined by paediatric GCS score as mild (9 patients), moderate (2 patients) or severe (4 patients). Blood samples for S100B serum measurement were taken at emergency department admission and after 48 h. Results: The serum S100B concentration was higher in the group of severe trauma patients, who scored the lowest on the GCS at admission, and among them, the highest values were reported by the children with concomitant peripheral lesions. Conclusions: The role of S100B in paediatric traumatic brain injury has not been clarified yet, and the interpretation of its increase when the head trauma is associated with other injuries needs the understanding of the physiopathological mechanisms that rule its release in the systemic circulation. The levels of S100B in serum after a brain injury could be related to the mechanical discharge from a destroyed blood-brain barrier, or they could be due to the active expression by the brain, as a part of its involvement in the systemic inflammatory reaction. Early increase of this protein is not a reliable prognostic index of neurological outcome after pediatric traumatic brain injury, since even very elevated values are compatible with a complete neurological recovery.

© 2007 S. Karger AG, Basel


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Article / Publication Details

First-Page Preview
Abstract of Original Paper

Received: November 16, 2005
Accepted: September 19, 2006
Published online: July 12, 2007
Issue release date: July 2007

Number of Print Pages: 7
Number of Figures: 0
Number of Tables: 3

ISSN: 1016-2291 (Print)
eISSN: 1423-0305 (Online)

For additional information: https://www.karger.com/PNE


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