Dynamics of the GCS, NSE and S100B Serum Levels and the Morphology of the Expansive Contussion in Head Injury Patients

Česká verzia

Authors: D. Vajtr ^1,3; R. Průša ¹; J. Kukačka ¹; L. Houšťava ²; F. Šámal ²; J. Pachl ⁴; J. Pažout ⁴
Authors place of work: Ústav klinické biochemie a patobiochemie 2. LF UK a FN Motol, Praha ¹; Neurochirurgická klinika 3. LF UK a FNKV, Praha ²; Ústav soudního lékařství a toxikologie 1. LF UK a VFN, Praha ³; Klinika anesteziologie a resuscitace 3. LF UK a FNKV, Praha ⁴
Published in the journal: Cesk Slov Neurol N 2007; 70/103(5): 515-520
Category: Original Paper

Práce je podporována grantem IGA MZ, reg.č. NR/8793-3/2006.

Summary

Introduction.
Laboratory diagnose of brain contussions is based on monitoring of proteins released to circulation (such as neuron specific enolasis (NSE) and S100B protein) from affected tissues. Morphological investigation of biopsy speciments proved focal changes of brain.

Methods.
The group (n = 20) of patients with focal traumatic brain injury was investigated. In 9 patients was found improvement of Glasgow coma score (GCS) up to 13-15 points during 10 days after admission (group I) and 11 patients had value of GCS less than 13 (group II).

Results.
We found the decrease of value of NSE and S100 b protein in group of all patients with focal brain injury during 10 days of hospitalisation. In 5 patients who died we observed the increase of NSE and S100B protein values on the. 2.-3. day. Patients with improvement of clinical status and GCS up to 15 points during 10 days of hospitalisation (group I) had lower value of NSE (33.53 vs 61.76 μg/l, p < 0.05) and S100B protein (0.61 vs 4.45 μg/l, p 0.05) 1-3 days after admission compared to values of group II. A morphological investigation demonstrated no damage of nucleolus of glial and ganglial cells, and pericytes digested the foregin proteins. Immuno-histochemical investigation proved diffuse positivity of anti-NSE, and CD68 antibody reacted around vessels microenvironment.

Conclusion.
Monitoring of serum levels of NSE and S100B is convenient and complementary investigation for monitoring of patients with TBI.

Key words:
contusion – Glasgow Coma Score (GCS) - neuron specific enolasis – S100B protein – electron microscopy – immunohistochemistry

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